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VOL. XLV. 



NEW YORK, JULY, 1910. 



No. 1 



H 



JOSEPH B. BISSELL^ M.D., 

Professor of Sursrery in the Medical Department of Fordham University, Surgreon to Belle vue 

and dv Vincent's Hospitals, Consultinsr Surg^eon to Hospital for De- 
formities and Joint Diseases. 



ATTENTION to details is one of 
the essentials to success in your 
calling, and in mine, too, for that mat- 
ter. The small details mean much to 
the patient; they mean more to you. 

All the rest of your life will be de- 
voted to work, and if you are wise, 
you will occupy a part of it in study, 
not necessarily in the study of books, 
but in the study of humanity as it comes 
before you — sick, suffering or well hu- 
manity, in its various phases, good and 
bad, saint or criminal, under such cir- 
cumstances and conditions as it is given 
only to nurses and physicians to see. 

A writer opposed to the three years' 
course of hospital training for nurses as- 
serts that the average length of the 
trained nurse's life is only ten years, and 
uses this as an argument against the 
present length of time which the nurse 
has to give up to the hospital training 
school. He thinks that three years' prep- 
aration for a ten years' vocation is un- 
reasonable and unnecessry. To me the 
argument appears a good one. It may 
interest us to consider for a moment what 
becomes of a nurse at the close of those 
ten years. 



Their ranks are depleted as follows: 

1. By matrimony, many marrying a 
patient, a doctor, the patient's brother 
or father, and not infrequently the con- 
solable widower, all of which may or 
may not be commendable, but is not con- 
ducive to continuing as a nurse. 

2. By illness, previously inherent in 
the system and excited by the hardships 
and exposure of hospital labor. 

3. By death, brought about by the 
severe and unaccustomed duties of nurs- 
ing, or coincident only. 

4. By promotion. Many of our New 
York pupils become superintendents of 
new schools throughout the country, or 
take a place in an executive capacity in 
private institutions. 

5. There are those who drop out and 
go into other occupations, or owing to 
changed circumstances or conditions, or 
the changed views of relatives, return 
to the homes they probably never ought 
to have left. 

Health, and robust health at that, is 
almost as necessary to a trained nurse 
as steam to a locomotive, without" which 
neither can go far. A nurse who is frail 
or weak or has constitutional tendencies 



*An address delivered before the Nurses of St. Vincent's Hospital and contributed to The 
Trained Nurse. 



THE TRAINED NURSE AND HOSPITAL REVIEW 



toward illness had better face the situa- 
tion squarely and bravely early in her 
career. Success in nursing is not for 
her. 

Neither is it for her who does not 
appreciate the seriousness of her choice 
of a livelihood, and who has ulterior 
motives in taking the hospital course. To 
both these I would say, even if you have 
been graduated, give up the work of 
nursing; you will very likely discredit it 
and yourselves. 

I would suggest as the first essential 
that you fall in love with your work 
after graduation. You are no longer 
under the discipline and direction of 
stern and unyielding authority, perhaps 
rebelled against, but invaluable to- you 
because it is authority and to be obeyed. 

In place of this authority, set a stand- 
ard for yourselves, set it high. You may 
never reach it, but it will stimulate you 
to try, and because of it you will strive 
and persevere and succeed. Upon such 
eflFort your success depends. The more 
you try the better you will do and the 
better nurses you will be. 

Don't set your standard beyond being 
a nurse; you are not a doctor nor a de- 
tective, and it is not intended that you 
shall in any way take the place of the 
one or the other. 

Don't undertake, because you think 
the physician in the case is giving the 
wrong drug, either through ignorance 
or criminal or murderous intent, to give 
an antodote or play the spy. There is a 
proper course for you to pursue in such 
cases. 

The occupation of nurse is an honor- 
able one, next, perhaps, to that of the 
sister of charity, the earliest type of 
trained nurse. 

Nursing implies the exercise of an ac- 
quired proficiency in certain more or less 



mechanical duties, and in this respect 
can attain almost to an art. The art con- 
sists in the ability to make an ill person 
comfortable in bed, also in carrying out 
the orders of the doctor, as completely 
as can be done without friction, and to 
the satisfaction of all the interested per- 
sons. 

You must be quick-witted, a good ob- 
server, conscientious, resourceful, of 
good judgment, diplomatic, and above all 
you must adjust yourself satisfactorily 
to the domestic arrangements of the 
family in which you are placed. 

In addition, if a surgical nurse, you 
must know how to clean your hands, the 
patient's wounds and skin, the instru- 
ments, prepare the room and the dress- 
ings, solutions, etc., again with the least 
disturbance to all concerned. 

When you take the pulse, temperature 
and respiration, do it gently, pleasantly 
and firmly; not aggressively nor per- 
functorily, but as things to be done to 
help the patient, and as if you liked to 
do them for that reason. 

An agreeable voice in the sick-room 
is a valuable asset; you must have it; 
cultivate it if you haven't it. 

Your manners are important ; the peo- 
ple you are with will expect refined man- 
ners of you. Manners may not make 
the man, but they will go a long way 
toward making you a successful nurse. 

Strive to be tactful to your patient; 
remember a sick man's character is 
changed, that the normal restraints are 
weakened and many frailties that good 
health hides are exposed when he is ill. 
Patience and tact will look beyond the 
present to the future. Don't sham a 
feeling or a pretense that you haven't 
got. 

The faculties of the sick are often very 



i in this respect 
irt. The art con- 
ike an ill person 
in carrying out 
, as completely 
rJction, and to 
interested per- 

\, a good ob- 
^urceful of 
nd above all 
tisfactorily 
^ts oi the 

ed. 

urse, you 
ands, the 
; instru- 
e dress- 
he least 

feature 

santly 
' per- 
ne to 
A to 

it; 
a- 



NURSING 



acute and the patient will see through 
you to your discomfort if you do. 

Ever strive to improve your knowl- 
edge. There is no reason why you should 
not be cultivated. Socrates was a stone 
cutter, Plato an itinerant seller of oil; 
the modern American philosopher, 
Thoreau, was a laborer. 

You can cultivate coarseness or re- 
finement, ignorance or intelligence. 
Choose the better part, enhance the value 
of your personality and your chances of 
success will be increased thereby. 

There are unpleasant things in your 
chosen life work, but do them; there is 
drudgery in it, there ought to be; there 
are hardships in it, there ought to be ; the 
experience is invaluable and develops 
your persistence and courage. 

Drudgery keeps us to our duty, it 
makes for strength of mind and determi- 
nation. All this is the discipline which 
brings out character. Character means 
success. A strong character based on ex- 
perience, determination and courage will 
never fail. 

Emergencies you will meet steadily and 
coolly ; for that purpose you are a trained 
nurse. But after all don't expect your 
nursing life to consist of emergencies. 
Life is made up of the little hardships 
and difficulties. The patient looks to you 
for relief from the tedium of bedridden 
existence, painful position, uncomfort- 
able headaches, lame muscles, mental pin 
pricks, the irritations of a fretful mind. 

If for any reason or diversion you 
shirk your work, you are a false nurse. 
False to your patient, false to your call- 
ing, false to the community which by 
implication you agree to serve, false to 



your moral obligations, 

Do your work thoroi 
ly, do it as if you wer 
proud of it. Don't do i 
reward alone, although 
not to be depreciated, 
worthy of his hire." Be 
of what you do huma 
proved, and the world i: 
it. 

We who live now a: 
ancestors; let us pay i 
this way our debts to 
preceded us, who worl 
ing honest and self-d< 
made ours the better ar 
this inheritance. We 
to return what little W( 
selfish service to our f< 

So you are to place 
your service in additioi 
take in it, as well as t 
suits which it will brin 

Steadily keep in vie^ 
duty to that society i 
life you are no unimp 
humble worker like yo 
is the elemental worker 
ant that you do your d 
fully, willingly and pu 
ing that every stroke 
brighten the burdens 
this great world that n 

Wherever you woi 
pointed lot, whether \ 
training school, genera 
to speak, or a humb 
ranks, do it proudl> 
faithfully. 

"Act well thy pai 
honor lies." 



fax t^t ^aVitng of tiie ^Batted 



CHARLOTTE A. AIKENS. 



IT is nearly eighteen years since Na- 
-*■ than Straus began in New York his 
memorable campaign against impure 
milk, and since that time the establish- 
ment of milk stations in congested cen- 
tres of population in the great cities has 
gone steadily on. It is one of the many 
lines of philanthropy in which private 
individuals or associations lead the way, 
demonstrate by a practical experiment 
what can be done, and how, when the 
experiment succeeds, and is clearly 
shown to be for the public good, it is 
practically certain in turn to be under- 
taken by the city and carried forward 
on a much larger scale. 

Having decided that the work needs 
to be done, and on the best way to at- 
tack the problem, the next step is the 
raising of funds. The sale of milk can 
be depended on for a part of the funds 
needed, but other means have to be used 
to meet the expense of establishing the 
stations, providing ice, literature, and 
the salary of the nurse or nurses, who 
are important factors in the movement. 

Public opinion is tending more and 
more to demand "pure" milk, in prefer- 
ence to "purified" or pasteurized milk. 
The so-called pure or "certified" milk 
is not always a possibility. It costs a 
good deal to produce it. Briefly stated, 
the requirements laid down by medical 
scientists for "certified milk" are about 
as follows : The cattle must be healthy. 
As a rule the tuberculin test is insisted 
on, and all known means to determine 
the physical condition of the animals are 
used. Milk should come from a herd 
rather than from a single cow. The 



food and water of the cattle producing 
the milk are important considerations. 
Distillery slop, and other such food, 
which causes the milk soon to decom- 
pose is forbidden. Foul water must not 
be allowed, and certain precautions re- 
garding changes from dry feed to grass 
must be observed. 

The cows must be curried and cleaned 
regularly, so that no particles of hair 
or loose dirt of any kind may get into 
the milk during the milking process. 
The hands of the milker must be clean, 
and clean, washable garments worn dur- 
ing milking. The udder of the cow must 
be washed just previous to milking. 
Specially constructed milk buckets, with 
a small opening are used, and this open- 
ing is covered with several thicknesses 
of sterile gauze. The milk must not be 
allowed to stand in the stable till the 
herd is milked, but is carried at once to 
the separator, which must be kept in a 
detached dairy house. 

Immediately after the milk passes 
through the separator (a standard per- 
centage of fat is provided for) it is ptit 
in a cooler and quickly reduced to a 
temperature of 45* F. It is then placed 
in sterile bottles, is capped with a dated 
cap, and packed in ice for shipment. 
Every garment, bucket or utensil com- 
ing in any way in the neighborhood of 
the milk, must be sterilized by steam be- 
fore using. This is the ideal toward 
which medical men and health boards 
are working. 

A great variety of methods of raising 
funds for the work of pure milk sta- 
tions have been tried. All such move- 



FOR THE SAVING OF THE BABIES 



merits as a rule start in a modest way 
with an equipment which is striking be- 
cause of its simplicity. Given an organ- 
ization under whose auspices the work 
of providing pure milk for the babies 
is to go on, and sufficient funds in hand 
are guaranteed to see the experiment 
safely through one season, and the work 
begins usually in one of the densely 
populated sections of a city. It is a help 
in the beginning, when the aims and 
plans of the milk station are not well 
understood by those who most need to 
patronize them, if an institution of some 
kind — hospital, dispensary, mission, set- 
tlement or institutional church — can be 
induced to lend a vacant room and the 
co-operation of one or more workers till 
the new work becomes established. This 
applies especially to work carried on by 
a new private organization. The Health 
Department in a number of cities has 
led in the work for the babies. Roches- 
ter, N. Y., has for long been conspicu- 
ous for the efficiency of its Health De- 
partment in this line of work, and the 
story as told by Dr. Goler, the health 
officer, of the modest beginnings of its 
work, is full of interest. 

"This is the way we began our work 
ten years ago,'' writes Dr. Goler. "A 
pamphlet of eight pages was published 
in English, German, Italian and Yiddish, 
containing, in the simplest form, the 
chief points relating lo the care and 
feeding of infants. It was entitled: 
'How to Take Care of Babies During 
Hot Weather' Across its face in large 
red letters was printed, 'Give the Baby 
Water.' In type large and distinct were 
these two sentences : *No other milk, no 
other food, not even a wet nurse can 
take the place of milk from the child's 
own mother.' 'Don't feed bananas, 
candy, popcorn, sugar or anything else 



tt ( 



« t 



tt t 



tt 



tt t 



tt I 



tt 



but milk unless told to do so by your 
physician.' 

"The headings of the pamphlet were : 

" TO KEEP A BABY WELL. 

1. Give it pure air day and night. 

2. Give it no food but mother's milk, 
milk from the bottle, or food di- 
rected by the physician. 

3. Whenever it cries, or is fretful, do 
not offer it food. Give it water. 

'4. Be sure that it gets enough sleep, 
two naps during the day at least. 

5. Do not put too much clothing on it. 

6. Bathe it in a tub every day. 
*7. Don't handle it; let it alone.' 

"These headings were briefly dis- 
cussed in the body of the pamphlet. 

"Then we started a milk station in 
charge of a trained nurse, with a woman 
assistant. In one of the most densely 
populous portions of the city, a vacant 
store was rented. Behind a rough coun- 
ter a large sink was installed and the 
necessary table, racks, etc., were erected. 
An oil stove furnished heat for the ap- 
paratus in use. Milk was procured from 
what the milk inspectors thought to be 
one of the best farms in the vicinity. 
It was prepared and sold at cost, varying 
from two four-ounce bottles for one 
cent, to one cent each for eight-ounce 
bottles. A deposit of three cents was 
required on each bottle and rubber cork. 
In the first instance, the mother or nurse 
was required to come to the milk sta- 
tion and bring the baby, where, in the 
absence of a physician, the baby was 
weighed, and a milk mixture prescribed 
according to the weight of the child and 
not according to its age. The nurse 
talked with the mother about the air, 
water, food, sleep, recreation and cloth- 
ing of her child, using the little 
pamphlet as her guide ; and then, giving 



THE TRAINED NURSE AND HOSPITAL REVIEW 



the mother one of the pamphlets, called 
attention to the care of the child as there 
directed. * * * We conduct our 
milk station work from July 5 to Sep- 
tember I, that being the time of year 
when babies most require clean milk. 
Each station is in charge of a trained 
nurse, who is provided with a table, 
chairs, scales for weighing the baby, a 
supply of pamphlets, paper and twine 
for wrapping up milk bottles, and a 
large refrigerator kept well stocked with 



ice." 

The average cost per year of this 
work in Rochester has been $1,000. 

In New York City the "Summer 
corps," so-called, was begun as far back 
as 1876, when a staff of physicians was 
appointed to serve for the Summer 
months, their services being offered to 
sick babies without medical care. 

Personal instruction of the mothers, 
which is now regarded as of as gfeat or 
greater value than anything else in the 
work for the saving of the babies, has 
been gradually developed. Within the 
past couple of years it has been carried 
out according to definite and compre- 
hensive plans, its main purpose being to 
keep the baby well. Last year the Di- 
vision of Child Hygiene of the Depart- 
ment of Health was created, and it was 
made possible for the preventive work 
to begin on April 15, instead of in 
July as previously. This compre- 
hensive plan of education resulted in a 
decrease, in 1909, of twenty per cent in 
the death rate of babies under two years 
of age, as compared with the previous 
year. 

Each nurse is assigned for duty to a 
definite district, and a scheme of co- 
operation between different agencies was 
arranged which prevented overlapping 
of territory and conflict in work. Speak- 



ing of the necessity for co-operation and 
consolidation of all existing agencies as 
an essential to success, Dr. Thomas 
Darlington, late Commissioner of Health 
of New York City, says: "It has pre- 
viously been comparatively common for 
mothers to be visited by nurses or 
agents from four or five different 
agencies, distributing as many forms of 
printed instructions, sometimes conflict- 
ing, and generally bewildering to the 
over-visited woman. The loss of total 
efficiency is evident. This year five differ- 
ent agencies have volunteered the ser- 
vices of nurses who have worked under 
the direction of the Health Department. 
It has a staff of its own numbering 141." 

Of all agencies laboring in behalf of 
the babies in New York City, the Asso- 
ciation for Improving the Condition of 
the Poor has been among the most ag- 
gressive and efficient. Through its ef- 
fort, the New York Milk Committee 
was organized, successfully launched, 
and financed in its early stages until it 
had demonstrated its usefulness and the 
time had come for it to become a separ- 
ate and independent organization. This 
association has a well-defined educa- 
tional policy, which has been adhered to 
with encouraging success for years, and 
which has been an inspiration to social 
workers in centres far from the metrop- 
olis. Junior Sea Breeze, its city camp 
for sick babies, has for four years been 
one of the important centres for such 
work. 

In Cleveland, the Babies' Dispensary 
and Hospital has within two or three 
years developed a work of no small pro- 
portions. In the Summer of 1909 it 
conducted four branch dispensaries for 
babies, an outdoor ward, and has car- 
ried on the work of providing the pure 
milk necessary. The story of its work 



FOR THE SAVING OF THE BABIES 



with and for the babies is as interesting 
as a fairy tale, and far more profitable 
reading than any such tale. 

In Indianapolis systematic work for 
reducing the number of deaths of babies 
due to diarrheal diseases has made a 
splendid beginning in the organization 
of the Pure Milk Commission, and has 
at least two seasons of work to its 
credit. 

The movement grows steadily. Sum- 
mer work is only a step to all-the-year- 
round work, for those who have most 
experience with the problem realize and 
admit that "putting forth our efforts to 
combat the diarrheal diseases of in- 
fancy at the time when they are at their 
height is but a partial move in solving 
the problem." 

"In the reduction of infant mortality," 
says Dr. Darlington, "and in the cam- 
paign for child health, many and diverse 
factors are concerned. Proper housing, 
sanitation, including ventilation and 
fresh air; the diminution of the evils of 



congested living quarters, a pure water 
and milk supply, pure food and hygienic 
personal habits must receive attention. 
Sanitary science has placed at our dis- 
posal the knowledge requisite for com- 
bating these evils; but corrective or re- 
pressive measures can never be wholly 
effective, and preventive means can suc- 
ceed only if people as a whole are re- 
ceptive and possess a spirit of co-opera- 
tion. This can only be attained by 
means of widespread education of the 
masses. In all large communities, the 
poorer element of the foreign-bom pop- 
ulation presents the greatest problem en- 
countered in municipal health work. Di- 
versified in their habits, often supersti- 
tious, and resentful of any interference 
with their mode of life, oppressed by 
poverty, frequently ignorant or neglect- 
ful of the simplest sanitary requirements, 
their assimilation as citizens of their 
adopted country comes only as a result 
of education, persistent, inclusive and 
never ending." 



Practical Points 



Dr. J. F. Edwards, superintendent of the 
Bureau of Infectious Diseases, Pittsburg, ad- 
vises all persons who cannot afford to own 
a refrigerator to adopt this plan for a sim- 
ple home-made ice box, which will preserve 
a five-cent cake of ice from twenty-eight to 
thirty-two hours: 

An ordinary wooden soap *box with a lid; 
two tin pails, one five gallons and the other 
three gallons ; a bucket of sawdust and a bun- 
dle of newspapers. 

Place the larger pail inside the box and 
pack the space between the pail and the sides 
of the box with sawdust or newspapers. 
Place the smaller pail with a piece of ice in- 
side the larger pail and fill it half full of 



water. The bottle containing the milk is 
placed inside the smaller pail. 

The lid of the box is covered with several 
layers of newspapers and kept on the box. 

+ 

A well-known orthopedic surgeon says: 
Regarding "plaster of Paris bandages," the 
water for immersing the bandages should be 
hot if it is desired that the plaster set quick- 
ly, and cold when the opposite is wanted. 
Salt will hasten the process. The padding 
for plaster of Paris splints should be the best 
quality of ordinary cotton. Absorbant cotton 
should never be used under plaster of Paris 
bandadges. For jackets, stockinette or neatly 
fitting shirts are best. 



^e\ienti) Sap 9ititientt£it Jiursed 



JAS. D. MONTGOMERY. 



THERE are nurses and nurses — 
nurses good, bad and indifferent. 
To the first named class of nurses we 
trust the readers of The Trained 
Nurse belong. In fact it is difficult to 
long read a journal of this kind without 
at least making some improvement. 
That is why we take it. And then we 
have male nurses and female nurses; 
religious nurses and nurses that are not 
so religious; nurses registered and un- 
registered; trained and untrained; grad- 
uate and "practical." Then, besides all 
these, we have with us the denomina- 
tional nurse, who is, we hope, not en- 
tirely distinct from all the others in per- 
sonal qualifications, but is somewhat dif- 
ferent from all, in that she is controlled 
and paid by some denomination, or 
church. It is of this class that I desire 
to write at this time. Not that I care 
to discuss the denominational nurse as 
a class, or as a whole, but the nurses 
of the Seventh Day Adventist Church 
in particular. 

Who are they? What are they? 
Wherein do they differ? How do they 
work? are questions that remain un- 
answered in the minds of many and it is 
miy intention to answer some of these 
questions in this article. 

I. "Who are they?" They are nurses 
trained in the sanitariums of the S. D. 
Adventist denomination. There are 
about one thousand of them in actual 
employment in the various sanitariums 
of the denomination at the present time, 
including undergraduates. There are 
probably that many or more that have 
been sent out to do work in home and 
foreign mission fields or to work inde- 



pendently. These 2,000 or more nurses 
are scattered all over this country, in 
Europe, and in the various mission fields 
of the world. 

This is not at all a large company of 
nurses, speaking in the comparative 
sense. There are as many or more nurses 
as this whole company in many of the 
large cities of the world. Hence it 
might seem that they are too small and 
insignificant to give special notice, and 
they indeed would be, were it not that 
there are some other questions about 
them to be answered. 

2. "What are they? Or perhaps I 
should say, "What are their principles?" 
For indeed it is this and this only that 
makes them differ from the great army 
of trained nurses all over the land. 

These principles cannot be entirely ig- 
nored, for the reason that a small army 
of nurses scattered abroad in the world, 
working along certain well defined lines, 
and on principles that differ materially 
from those of other schools, cannot but 
have an influence that will, to a certain 
degree, mold professional and public 
opinion in regard to the best methods of 
nursing. Whether these methods are bet- 
ter, and whether the principles are cor- 
rect, must be decided by the individual 
reader for himself. However that may be, 
if their methods appeal to only a part of 
the doctors, or even the patients, it will 
be harder for the next nurse to give en- 
tire satisfaction, unless she, too, can ap- 
ply the methods of her predecessor. 
This influence is, and will continue to be, 
an unconscious leaven in the world mold- 
ing the demand for nurses* services. 
And, may I suggest, the only way to 



SEVENTH DAY ADVENTIST NURSES 



meet this thing is to become familiar 
with these methods and the reasons 
therefor, and thus be able to fill the de- 
mand wherever met. It is for this pur- 
pose that I have undertaken to outline 
the matter in these articles for the read- 
ers of this journal. 

In some things, yea in many things, 
the S. D. A. nurse is like all other 
nurses. In ethics they are taught to 
carry out the Golden Rule and treat all 
others as they would that all others do 
to them were circumstances reversed. 
This is believed to be pure ethics, both 
professional and social. This, we be- 
lieve, covers all points in the much dis- 
cussed matter of "Nursing Ethics." 

In training they receive about the 
course of the average nurse, with the 
addition of the matters yet to be men- 
tioned in these papers. 

In surgery and surgical nursing the 
instruction differs but little from that 
received in any hospital training school, 
with the exception of some things in 
post surgical nursing. 

In anatomy, physiology, hygiene, ma- 
teria medica, and the various lines taught 
in training schools the instruction is 
about the same. In physiology there is 
much stress laid on the care of the body 
in health as well as in disease, because 
it is taught that our bodies are the 
"Temples of the Holy Spirit," and as 
such they deserve a very careful study 
with the view to preservation. In ma- 
teria medica the use of the various drugs 
is taught, and also the abuse thereof, 
and the danger attending their use. That 
is, the untoward effects are pointed out 
as well as the more harmless effects. Of 
course everybody understands that all 
drugs are foreign to the body and are 
treated by the body as foreign matter 
and as such are to be eliminated as 



quickly as possible. It is this action on 
the part of the body that makes most 
drugs at all valuable. Were this not so, 
of what value would cathartics and such 
like be worth? And so it is with many 
other substances used as medicine. The 
body regards them as an enemy and the 
vital forces are quickened to overcome 
and to eliminate the drug, and these 
stimulated vital processes may perchance 
overcome the disease at the same time it 
is trying to overcome the drug. This 
beneficial action is pointed out to our 
nurses, and then the danger of over- 
drugging, and useless drugging, is also 
impressed upon their minds. It will be 
noticed that all S. D. A. nurses are ex- 
tremely careful in giving medicines, al- 
ways remembering that any mistake in 
medicine giving may cost the life or 
good health of the patient. 

In the anatomy classes we study the 
structure of the body with the thought 
kept prominent that we are the handi- 
work of God, made after a definite pat- 
tern, made in the likeness of our Maker. 
"I will give thanks unto Thee for I am 
fearfully and wonderfully made . . . 
my frame was not hidden from Thee 
when I was made in secret . . . 
Thine eyes did see mine unformed sub- 
stance, and in Thy book were they all 
written, which day by day were fash- 
ioned, when as yet there were none of 
them." — Ps. 139; 14-16 R. V. These 
thoughts make the study of form and 
structure anything but dry and dull. It 
gives zest and interest and much benefit 
to what is usually regarded as the dryest 
and the hardest of all the studies that 
go to make up a curriculum for nurses. 

The theory of disease as given by one 
of the most voluminous as well as the 
most revered writer in the whole denom- 
ination is as follows: 



10 



THE TRAINED NURSE AND HOSPITAL REVIEW 



"Disease is an effort of nature to free 
the system from conditions that result 
from a violation of the laws of health." 
— Ministry of Healing; P. 127. And 
again, "Nature bears much abuse with- 
out apparent resistance; she then 
arouses and makes a determined effort 
to remove the effects of the ill-treatment 
she has suffered. Her effort to correct 
these conditions is often manifested in 
fever and various other forms of sick- 
ness." — P. 235. It may be said by some 
that this is not true in the case of infec- 
tious and contagious diseases, but it is 
held and taught by this people that even 
contagion is not possible if the body is 
entirely normal. It is also held that the 
resulting sickness from exposure to in- 
fection is the effort of the system to rid 
itself of this particular poison. 

The theory of germ action in disease 
is not denied, so far as I know, by the 
doctors and nurses of this denomination. 
But it is not probably taken quite so lit- 
erally as is done by many schools. They 
seem to hold more to the idea of poor 
health resulting from bad personal hab- 
its which lower the resistance of the sys- 
tem and thus let down the bars to the 
various infectious diseases that flood the 
world at this time. 

It is recognized by all that the life has 
much to do with one's state of health. 
If the habits be those of a glutton or 
drunkard we do not at all expect them 
to resist the ravages of disease as will 
those whose habits are correct. It is 
conceded that consumption is caused by 
poorly ventilated sleeping and living 
rooms and sedentary habits. It is also 
recognized by all that unsanitary condi- 
tions will soon breed typhoid, yellow 
fever, and many other diseases. And 
we believe that if the matter were sifted 
down to its fountain head it would be 



found that all diseases are the direct or 
indirect result of sin. 

The above view of the cause of dis- 
ease will of itself reveal what the treat- 
ment of disease should be. If being out 
of harmony with law is disease, it nat- 
urally follows that being in harmony 
with law is health. And if harmony 
with law is health and prevention from 
disease, then the process of healing is no 
more than the operation of getting back 
into harmony again. This may be ac- 
complished in different ways, and these 
"ways," as it were, are the difference 
between nurses of this denomination and 
those trained elsewhere. What these 
"ways" are and the method employed in 
administering them we will reserve for 
another article. 

This idea of getting the patient back 
into harmony with nature for the cure 
of his troubles very largely supplants 
the use of poisonous drugs and other 
medicinal remedies. We aim to assist 
the operation of natural laws in their ef- 
forts to restore the body to the normal 
condition. How may we be of assist- 
ance? What can we do to help? We 
can only help in two or three ways. We 
can remove the cause as far as possible ; 
we can remove obstructions, as in the 
case of the bowels and pores of the skin ; 
we can alleviate pain and discomfort; 
we can then sit down and watch "the 
Lord that hcaleth thee" operate through 
His law. This is not much by way of 
remedy, but it is usually found sufficient 
for cases not too far gone to recuperate. 
The Bible does not say very much 
about remedies. In fact, prevention is 
the sovereign remedy set forth in the 
Scriptures. Do not contract disease is 
the advice of the Great Physician. And 
yet, in a general way, there is a remedy 
mentioned in the Word that may be ex- 



SEVENTH DAY ADVENTIST NURSES 



11 



pressed in one word, repentance. Re- 
pentance means sorrow for wrong doing 
and the turning away therefrom. When 
one is overtaken in a physical fault he is 
to rightabout- face and march the other 
way. In fact, one's health always de- 
pends upon this very thing. There can 
be no exception to this rule. There 
never was one — never will be one. 

In dealing above with some of the 
principles by which our nurses work I 
intimated that I would try to point out 
some of the means by which they car- 
ried out these principles. Some of them 
are as follows : 

In the medical creed of this people is 
an article stating that the use of poison- 
ous drugs is not necessary in the treat- 
ment of disease. There is a general un- 
derstanding that these drugs are unneces- 
sary in both health and sickness. Hence 
it is necessary to provide some other 
means to combat the untoward symp- 
toms that arise in all critical cases. 
Some of these are given below : 

Instead of strychnia and other cardiac 
stimulants they use the cold applications 
or perhaps the alternate hot and cold as 
the needs may be. These applications 
rightly applied may be made to act both 
as a heart stimulant and also as a seda- 
tive, and that almost instantaneously. 

Calomel is considered by the profes- 
sion at large as an efficient cholagogue, 
but our nurses regard the hot and cold 
alternate application to the area over 
the liver as more efficient than the chlo- 
ride and much less dangerous. They also 
recognize the specific action of certain 
fruits and use them as occasion may in- 
dicate. 

The saline laxatives and other drugs 
are used to induce movement of the 
bowels, but these nurses have learned to 
value the enema as more desirable in 



many ways. Also they are trained to 
diet for the same results, and, as a con- 
sequence, benefit not only the bowels but 
the general health also. 

Nux vomica, hydrastis, arsenic, etc., 
are supposed to be fairly good stomach- 
ics, but we regard the fruit acids, as 
grape fruit, limes, etc., as superior with- 
out the attending danger. But as a gen- 
uine gastric tonic nothing aside from 
food can at all compete with the al- 
ternate hot and cold applications to the 
epigastric region. These are regarded 
by the nurses under consideration as 
safer and better in that there is abso- 
lutely no untoward after effects. 

Morphia and other drugs are consid- 
ered good nerve sedatives, but our peo- 
ple only resort to them in extreme emer- 
gencies. For a nerve sedative it has 
been found that hot applications to the 
spine and massage give excellent results. 
Again there is noted no ill effects from 
their use, but rather benefits accruing 
rapidly. 

There are various medicines used as 
anodynes, but we find in our simple tis- 
sue-relaxing hot applications pain-reliev- 
ing effects powerful enough to relieve 
most aggravating pains. 

Acetanilid may be a specific headache 
remedy, but we find that headache 
may usually be relieved without resort 
to this remedy. Headache is usually re- 
lieved by a common hot foot bath, and 
may be entirely cured by finding the cause 
and removing it. The cause for many 
a headache may be found in intemper- 
ance at the table. Hence the removal of 
the cause and other means will entirely 
cure the troublesome headache. Drugs 
cover up the ache — rational remedies re- 
move it. 

Salol and phenacetin are used freely 
as an antithermic agent, but the better 



12 



THE TRAINED NURSE AND HOSPITAL REVIEW 



antipyretic we find in the judicious use 
of hydrotherapy. There are various ap- 
plications in use for this purpose, but I 
may not attempt to describe these meas- 
ures, as much harm may be done by the 
novice attempting to reduce temperature 
by these means. 

Digitah's, ergot, ipecac, are considered 
fair antiphlogistics, but we regard them 
as comparatively inefficient to what is 
termed the rational remedies. To re- 
duce local inflammation the application 
of cold is regarded efficient by those 
using these methods. Continuous cold 
application will reduce the most violent 
inflammation if rightly applied. 

There are many drugs used as a gen- 
eral tonic with indifferent results. The 



proper use of hydrotherapeutic measures 
will produce the desired effect rapidly 
and well. Thus we find that in the use 
of remedies the company of nurses un- 
der consideration work on entirely dif- 
ferent lines from those of most other 
schools. We have not space nor time 
just now to go farther into the princi- 
ples and practises of Seventh Day Ad- 
ventist nurses, but I may say that I have 
merely touched upon the subject. In 
ways innumerable and under circum- 
stances variable and at times distressful 
these faithful nurses apply these princi- 
ples, and to the uninitiated it seems won- 
derful what can be done by such simple 
means if only one knows when and how 
to use them. 



California. 

The Ninth Annual Commencement exercises 
of the Agnew Hospital Training School for 
Nurses, San Diego, were held Thursday even- 
ing, June 2d, at the San Diego club house. 
There were musical selections, an address by 
Dr. Anita Newcomb McGee, presentation of 
diplomas by Dr. F. L. Magee, and presentation 
of pens by Dr. J. Perry Levis to Miss Karen 
Rohde, Miss Marcia Emily Roth, Mr. Ellery 
Alexander McDowell, Miss Mary Katherine 
Small and Miss Mayme Chalfont, graduates, 
and to Miss Sabina Charlton and Miss Eliza- 
beth Irene Burns, post-graduate. A reception 
followed the exercises. 

+ 

Personai. 

Miss Mary W. Vare, of Hammonton, N. J., 
a graduate of the Pennsylvania Orthopaedic 
Institute and School of Mechano-Therapy, 
Philadelphia, Pa., has been engaged by Dr. 
Strong's Sanitarium, Saratoga Springs, New 
York, to succeed Miss Helen M. A. Grant, 
also a graduate of the Pennsylvania Ortho- 



paedic Institute, to take charge of the Me- 
chanical Department of the sanitarium. 



Miss Grace E. Stamp, R. N., graduate of 
Mt. Sinai Hospital, New York City, and 
formerly Superintendent of Nurses James 
Walker Memorial Hospital, Wilmington, N. 
C, has assumed charge of Orange Memorial 
Hospital, Orange, N. J., with Miss Anne Mac- 
Edwards, R. N., also of Mt. Sinai Hospital, 
as Assistant Superintendent. 



Miss Carrie I. Farrington, formerly in 
charge of the Woman's Department of the 
Utah Hot Springs Sanitarium, has resigned 
her position and is taking post-graduate work 
at the Battle Creek Sanitarium. 



Mrs. J. B. Lang, of Bishop Memorial 
Training School, Pittsfield, Mass., 'go, who 
has been conducting Lang Sanitarium, Water- 
bury, Conn., has given up same and taken 
Laurel Beach House, Laurel Beach, Conn., 
which she will conduct as a Summer hotel. 



dome $otntfi( in tt)e Care of t|)e ^mmt 



ANNE E. PERKINS^ M.D. 



IN spite of the reforms in the treat- 
-*• ment of the insane that have led to 
the abolition of padded cells, the knock- 
ing off of fetters and chains, minimizing 
restraint, naming the refuges hospitals 
instead of lunatic asylums, we have yet 
much to change. 

There remains a widespread miscon- 
ception of insane hospitals — a strong 
prejudice against them. We hear peo- 
ple speak of the great abuse patients re- 
ceive and say that they would prefer 
their relatives or friends to die before 
going to such a place. If they are 
shown all over a hospital they will ask 
if there are not worse wards where no 
one is allowed. When shown the most 
violent wards they ask if there is not 
still a chamber of horrors. They ex- 
pect so much noise and violence. In fact, 
they have an idea that really "crazy" 
people are raving maniacs, senseless and 
dangerous. There is a popular fear of 
the insane even among some physicians 
and most general hospital trained nurses. 

This leads to much deception on the 
part of relatives. Before a patient is 
taken to the hospital, to make it easier 
and smoother for the family, the pa- 
tient is often told he or she is going to 
a hotel to board, or to a private sani- 
tarium; or more often, that a fine posi- 
tion has been secured for them at some 
distance. The most elaborate falsehoods 
are "framed up," as that the physician 
or attendant is a distant relative and 
will take them to meet a son, husband, 
mother, etc. 

Beware of lies to an insane patient. 
They are unnecessary, inexcusable, and 
diminish the chances of the patient's re- 
covery; for it is absolutely necessary to 



establish and maintain a patient's confi- 
dence. If their initial attitude is one of 
suspicion and hate because they have 
been deceived, little can be done for 
them. 

And so the law in New York requires 
that the patient shall be told where he is 
being taken and why. 

Patients should be searched before 
taking them to a hospital, as they not in- 
frequently have concealed knives, re- 
volvers, morphine, whiskey or poison on 
their persons and may kill themselves or 
others. On the way to the hospital they 
cannot be left alone an instant lest they 
escape or commit some overt act. Many 
a patient has escaped a nurse while she 
telephoned and turned her back for an 
instant, or because a request to "step into 
the next room or bathroom a moment" 
was granted. Show no fear of the in- 
sane and treat them as sick people. If 
cases are kept at home the greatest care 
and watchfulness is necessary to guard 
against homicide or suicide. One often 
reads of a patient at home who hanged 
himself or herself "while the nurse slept 
for an hour." Constant vigilance is re- 
quired, especially with depressed cases, 
for often suicide is not merely an im- 
pulse, but an obsession — ^brooded over, 
the way planned, the opportunity 
watched for so closely that three min- 
utes' leeway may give the chance. Win- 
dows must be arranged not to open over 
six inches, all possibly injurious medi- 
cines or poisons locked up, matches and 
scissors put away, unless some one is 
present. 

One patient in a sanitarium took 
Fowler's solution. Another who was not 
suspected of suicidal tendencies was 



14 



THE TRAINED NURSE AND HOSPITAL REVIEW 



given a parole and unfortunately allowed 
money ; he bought a revolver, came back 
and shot himself. 

Patients everywhere, especially in hos- 
pitals, should have their clothes, &c., 
searched each night. Some secrete to- 
bacco, others make most ingenious keys 
from the aluminum combs and escape 
thereby. A great variety of weapons 
may be found, as stones tied in a hand- 
kerchief to use as a slung-shot, door 
knobs, and even balls of tinsel from to- 
bacco, solidly molded together, primitive 
knives, &c. Suicidal cases often secrete 
the strong scrubbing soap and eat it, or 
seize the turpentine that is being used 
on the floor. Some break windows and 
secure a piece of glass. One patient 
broke a jelly glass on her tray and hid a 
sharp triangle. Just as she was about 
to use it on her throat a patient called 
the nurse. One patient received a box 
of candy from which the tongs were not 
removed and sawed the arteries in her 
wrists. A suicidal patient will take the 
cord of a bathrobe or hem of a sheet to 
hang herself. Patients should never be 
left alone in water section or bathroom. 
Some have stood on their heads in buck- 
ets of water and drowned, or in taking a 
bath they are liable to scald themselves, 
especially if they are demented or gen- 
eral paralytics with impaired sensation. 
It would be well for all general hospital 
nurses to take a course of at least nine 
months in an insane hospital to cultivate 
general watchfulness and observation, 
learn the application of packs, baths and 
hydrotherapy in general, tube-feeding, 
&c. This training develops an acuteness 
•hat prevents accidents and suicide. The 
nurse learns to keep her head and act 
quickly. I recall a case where a parole 
patient in one institution was considered 
nearly well and showed no signs of de- 



pression. During the night the nurse 
heard a slight unusual sound and went, 
on a sudden impulse, the rounds of the 
ward. She thought it must have been a 
patient snoring, as all was quiet. Pres- 
ently this patient went by her to the 
water section, as she frequently did. 
Again an irresistible force made the 
nurse rush after. She found her sawing 
at her throat with a narrow piece of 
glass she had secreted during a walk. 
The noise heard was air from the sev- 
ered trachea. She wrested it from her, 
carried her into a room where a nurse 
was sleeping, waked her and had her call 
a doctor, then quietly removed all traces 
of blood so that the other patients were , 
unaware of what had transpired. 

Great tact is necessary with many of 
the insane to make them eat, bathe, or 
do the simplest things for themselves or 
in the line of helpful employment. Those 
who are not ill physically are much bet- 
ter when employed, under supervision. 

A patient cannot be disciplined. One 
can be firm but still polite. Study the 
patient's peculiarities. Do not speak 
harshly and never lay a hand on a pa- 
tient if it can be helped — i. e., to take 
them by the arm or shoulder with a show 
of authority and demand that they sit 
down or go back to bed. Most patients 
will resent it and perhaps attack the 
nurse« 

Be careful what you say, for it must 
always be remembered that many ap- 
parently hopeless cases recover and re- 
member and relate accurately much that 
occurred. Never threaten a patient that 
if she does not do this or that you will 
punish her or withdraw some privilege. 
Patients may talk most abusively, pro- 
fanely, obscenely, accuse the nurses of 
gross abuses, but one must always re- 
member that they are irresponsible. And 



THE CARE OF THE INSANE 



15 



after all, we do hot know what we our- 
selves or our own may come to, and 
should treat patients as we should want 
to be treated. 

Patients, unless absolutely demented, 
always have some reason, however ab- 
surd to others, for what they do ; try to 
get at this. Some will not eat for months 
and have to be tube- fed. Later one may 
learn that the patient had her reasons — 
thought she should not eat, as it was 
wrong or that she would starve herself, 
or that the food was poisoned or con- 
tained snakes, or that the world would 
he ruined if she touched food. Some of 
(hem go on calmly thinking that they 
have not received any food, in nasal 
tube-feeding, and assert that it has not 
reached the stomach. With these feed- 
ing through the mouth by passing the 
tube, after holding the teeth apart by a 
mouth gag, is often helpful, and they 
w'll begin to eat sooner. 

It is useless to argue with any patient 
or to try to talk away a delusion, and say 
that it is absurd and ridiculous. You 
only antagonize the patient so that per- 
haps she conceals her delusion. If it 
could be explained away it would not be 
a delusion. A delusion is a falsd belief 
that no amount of explaining can ban- 
ish. The patient will not — cannot — ac- 
cept even the evidence of sight and 
sound. 

There are very few cases that should 
be cared for at home. Certainly it is 
wiser to take them away from the en- 
vironment or personal factors that have 
entered into their trouble. One's own 
are generally the worst people for them 
to be near. 

All acute cases, melancholias, epilep- 
tics and general paralytics should be 
taken from their homes. Insane epilep- 
tics may be very dangerous — often kill 



others while having an epileptic equiva- 
lent, and remember nothing about it. 
It is better for the relatives not to be 
continually harassed and upset by the 
presence of an insane person in the 
house. The danger is very great in all 
cases of depression, as it is easier to 
obtain means of ending life. These 
cases do better in the hospital or sani- 
tarium when they do not see their rela- 
tives often, as they usually are made 
worse by visits. Here they should be 
put to bed at first, treated as sick people, 
as they generally are, not merely in 
mind and nerves, but physically, from 
eating too little. They should be en- 
couraged in a general way without ab- 
solutely denying their ideas of hopeless- 
ness and commitment of the unpardon- 
able sin, etc. They may be told that we 
hope by and by things will be better, 
look different; that they are ill, and 
when they are stronger they can see how 
much brighter life is than they thought. 

The bowels of all insane patients must 
be watched carefully, as many are so 
engrossed in their delusions and others 
so demented as to pay no attention to 
the calls of nature, and accordingly be- 
come very constipated or have a result- 
ing diarrhoea. Many would never ask 
for water, and should be frequently 
offered it. 

Apathetic and lethargic cases should 
have cool morning sprays, unless other- 
wise ordered by the physician, and these 
are helpful for masturbating cases. Ex- 
cited and nervous cases do better in a 
prolonged warm bath, loo degrees, and 
may be kept there from a few hours to 
days. Massage, packs, plenty of hot 
milk or cocoa will do wonders for these 
cases. Often they have taken insuffi- 
cient food for weeks and are badly 
nourished and need hyper-feeding. Hyp- 



16 



THE TRAINED NURSE AND HOSPITAL REVIEW 



notic5 should be generally avoided. 
Amenorrhoea is very frequent, and a 
source of anxiety to the family. It often 
continues for several years in a young 
woman, though she may not be neces- 
sarily in bad physical condition. Sleep 
can be prolonged an hour in the morn- 
ing by the simple expedient of darken- 
ing the window in the early hours. The 
nsane often wake with the first ray of 
light and do not sleep after. 

It is easier to care for those actually 
ill than for the convalescent or chronic 
cases, but for these some suitable em- 
ployment and amusement must be 
found. Sometimes a patient will do fair 
work for a week, to Her own great ben- 
efit, on the promise of a trolley ride, a 



handkerchief, ice cream or candy. But 
promises must be scrupulously kept. 
Choose for suitable cases appropriate 
books, or let them have magazines and 
look at pictures. Picture puzzles help 
some to pass the time, and simple games, 
as checkers, dominoes and cards. Many 
do fancy work and sewing or help in the 
ward, and it is always a gain if a pa- 
tient can be interested in the ward. 

If someone accompanies them in their 
walks and calls attention to birds and 
flowers, some will grow to take an in- 
terest in these, will keep a list of those 
seen, and gather flowers for study, es- 
pecially if they have some simple book 
illustrated. 



CLASS OF I9IO, ST. LUKES HOSPITAL, OF BALTIMORE CITY. 



lose standing, from left to right, are: 

Dard and Maile M. Snyder. SlttlnK: 

Superlnt«ndeDt of Nuraes: 



Nellie M. Hutchli 



Imma Mal»y. Maud B. Gray. Edna H. Bar- 

.- " Muman. S. Elliabeth Hurren, 

and Sva b. Qlbson. 



f^"'/ 



€ltmtnatt\)e anti Conte 3Bati)£(« anti ^tf^tx 

Cteatment for Cojcemta 



MARY H. TUFTS. 






AT the present time many physi- 
cians hold the theory that a large 
number of diseases are caused by, or 
associated with, toxemia or autotox- 
emia. 

This paper is intended to outline as 
briefly as possible the hydriatic meas- 
ures and some other treatments often 
used with success in the conditions of 
toxemia. 

The old saying, "A little learning is 
a dangerous thing," may well apply to 
the application of hydrotherapy treat- 
ments. A nurse should never attempt 
to carry out a course of this kind of 
tieatment without the sanction of the 
patient's physician. 

According to many of the most emi- 
nent authorities, water is more nearly 
a panacea for all human ills than any 
other known agent. The physiological 
effects of water are due to those quali- 
ties which enable it to be used: i. As 
a nutrient, entering into the composi- 
tion of every structure and serving a 
useful purpose in nearly every function, 
especially as a vehicle for conveying 
food material to the tissues, and in re- 
moving wastes. 2. As a means of ab- 
stracting heat from the body by contact 
and evaporation. 3. As a means of 
communicating heat to the body. 4. As 
a means of producing certain mechan- 
ical or percutient effects. 

Other agents, as hot and cold air, hot 
vapor, electric light, sunliglit and mas- 
sage, are capable of producing similar 
effects, and these means are very gen- 
erally employed in connection with 
water in hydrotherapy. 



In toxemia, the effects to be gained 
by treatment may be briefly stated as 
follows: The general vital resistance 
must be increased, the toxins destroyed 
or eliminated, and bacteria destroyed 
and eliminated. 

Vital resistance has been defined as a 
property of the individual cell. There- 
fore, to increase the vital resistance, the 
energy and activity of the cell must be 
increased. And hydrotherapy can do 
much toward accomplishing this, if 
used in a rational and scientific man- 
ner. 

Applications of cold are of value 
through their exciting or tonic effects. 
The most useful of these procedures 
are: i. Wet hand rubbing. 2. Cold mit- 
ten friction. 3 Cold towel rub. 4. Wet 
sheet rub. 5. Dripping sheet. 6. Shal- 
low bath. 7. Pail douche. 8. The wet 
sheet pack. 9. The wet girdle. 10. The 
chest pack. 11. The rubbing sitz. 12. 
Alternate sponging of the spine. 13. The 
alternate spinal compress. 14. Cold 
water drinking. 15. The small cold 
enema. 16. Showers and percussion 
douches. 

Any of these tonic procedures may 
be preceded by a short hot application 
as a preparation for the cold applica- 
tions, but the hot application must be 
very brief, and the cold application be 
sufficently prolonged to produce the 
dominant effect. It is to be remem- 
bered that cold is primarily a depressing 
agent, and therefore applications in- 
tended to increase vital resistance must 
be very brief and must be promptly fol- 
lowed by reaction. 



18 



THE TRAINED NURSE AND HOSPITAL REVIEW 



The lower the temperature of the 
application, if the duration be short, the 
more highly tonic will be the eflfect. 

Cold applications first quicken then 
slow the action of the heart, raise the 
blood pressure and increase the move- 
ment of the blood and the lymph 
through their proper channels in all 
parts of the body. 

All procedures which encourage 
vital resistance, encourage the destruc- 
tion of toxins by stimulating the toxin - 
destroying cells of the thyroid gland, 
the liver, the spleen, the lymphatics and 
other tissues. The hepatic douche and 
the splenic douche increase the activity 
of these two largest glands in the body. 
A general cold douche powerfully stim- 
ulates all the bodily activities by which 
the destruction of toxins is promoted. 

Bouchard and other eminent writers 
have shown that the perspiration of the 
ordinary healthy person contains great 
quantities of toxic matter. Therefore, 
eliminative baths, especially the electric 
light bath, the sweating wet-pack and 
the vapor baths are valuable means for 
encouraging the elimination of toxins 
resulting from bacterial action or per- 
verted metabolic processes. 

The kidneys, liver and bowels are the 
most important outlets for toxic sub- 
stances and waste. The liver dispose? 
of alkaline waste, the kidneys remove 
urea, uric acid and other products of 
deficient oxidation, and a great number 
of toxins are eliminated through the in- 
testines. 

Water is said to act as a germicide 
by increasing the alkalinity of the blood, 
and especially by increasing leucocyto- 
sis, and the activity of the lymphatic 
glands and other organs capable of de- 
stroying bacteria. 

Leucocytosis is of great importance 



as a means of combating bacterial in- 
fection. And it is said that by the regu 
lation of the local blood movement and 
volume, leucocytosis may be encour- 
aged to almost any desired degree. 

Winternitz, Thayer, Thermes and 
others have shown the influence of the 
general cold bath in producing general 
leucocytosis. And local leucocytosis 
may be produced to a remarkable ex- 
tent by the heating compress frequently 
renewed and by the alternate compress. 

Strasser and others have shown that 
the cold bath increases the absorption of 
oxygen and the elimination of the CO2. 
And by the employment of hot baths in 
such a way as to elevate the body tem- 
perature, the oxidation of proteid sub- 
stances is increased. 

Cold applications for the purpose of 
increasing oxidation should be general 
in character; or, at least, should be ex- 
tensive enough to lower the body tem- 
perature a few tenths of a degree, in 
order to develop the reaction necessary 
to increase heat production, and, con- 
sequently, consumption of the carbona- 
ceous elements. 

The treatments most effective for 
stimulating oxidation of fats and car- 
bohydrates are the cold immersion, the 
plunge bath and the cooling pack. 

The most effective means of stimu- 
lating nitrogen oxidation are by the 
hot immersion bath, the heating pack, 
the hot dry pack, the vapor, hot-air and 
Turkish baths, sun bath and elec- 
tiic light bath. These general hot ap- 
plications to be followed by a very 
short, cold application to counteract the 
depressing effect of the hot bath and to 
restore the tone of the skin. 

In most forms of chronic disease there 
is grave disturbance of the general nu- 
trition, arising from the failure of the 



ELIMINATIVE AND TONIC BATHS 



19 



tissues to maintain normal metabolism. 

Hydrotherapy is an efficient measure 
by which the sluggish organs are awak- 
ened to normal activity, provided the in- 
tegrity of their tissues has not been ex- 
tensively damaged. The same measures 
used to increase vital resistance may be 
used to encourage general and local 
metabolic processes. 

The development of invading bac- 
teria in cases of infection may be de- 
layed by prolonged application of cold, 
when it is possible to make the applica- 
tion directly to the part involved. When 
deeper parts are effected, the growth of 
parasites may be combated by increas- 
ing the alkalinity of the blood by means 
of general cold applications and by the 
application of measures already de- 
scribed for favoring local leucocytosis. 

We are taught that stasis of the 
blood and lympth encourages morbid 
processes by favoring the development 
and the accumulation of waste and toxic 
substances in the tissues, thus leading to 
unhealthy tissue formation, and by weak- 
ening the resistance of the cells, which 
become poisoned by their own excretions 
>o that they are unfitted for combat with 
invading parasites. 

The same measures which have been 
f^escribed as favoring leucocytosis may 
be successfully employed in relieving 
stasis of the blood. 

A summary of the organic changes 
produced by heat and cold may be 
grouped as follows: i. Elevation of the 
body temperature is accompanied by in- 
crease of metabolism. 2. A fall of tem- 
perature is accompanied by decreased 
metabolic change. 3. Short cold appli- 
cations cause rise of temperature and in- 
crease of metabolism. 4. Prolonged 
cold applications cause fall of tempera- 
ture and diminished metabolism. 5. 



Short hot applications cause fall of tem- 
perature, with diminished metabolism. 6. 
Prolonged hot applications cause rise of 
temperature and increased metabolism, 
especially increased oxidization of al- 
bumin. 7. No disturbance of metabolism 
occurs as the result of baths at neutral 
temperatures, or while the body temper- 
ature remains normal. 8. Strasser has 
demonstrated increased alkalinity of 
the blood after cold baths, and diminu- 
tion after hot baths. 9. Jardet has dem- 
onstrated that the acidity of the urine is 
decreased by warm baths, and may even 
become alkaline. 

In febrile conditions, when heat pro- 
duction is increased, antipyretic appli- 
cations do not lessen the heat production 
unless applied in such a way as to cool 
the muscles and produce a diminution 
in the general body temperature. 

The primary effect of cold applica- 
tions is to increase CO2 production. In 
the reaction period there is elevation of 
temperature, which, if sufficiently pro- 
nounced, is accompanied by an increased 
oxidation of albumin. 

In the treatment of toxemia by hydro- 
therapy, massage and other allied meas- 
ures, we must not forget that it is the 
patient and not his disease who is to be 
treated. The present day teachings tend 
toward the conclusion that the curative 
forces reside in the body, and all efforts 
toward cures must be made to supply 
such conditions as will sustain and aid 
the natural forces of the body to regain 
their normal balance. Therefore, we 
must consider the causes underlying the 
patient's disease. In toxemia, as in 
other abnormal conditions, we usually 
lind that faulty habits of living have 
much to do with the condition. 

In chronic diseases we have two gen- 
eral classes to deal with : those in which 



20 



THE TRAINED NURSE AND HOSPITAL REVIEW 



the seat of the disease is a local irrita- 

m 

tion of mechanical or other origin, or in 
which there is a local mechanical or tis- 
sue injury. 2. Those due to a diathesis 
or a constitutional condition. 

Therefore, a thorough and scientific 
examination of the patient should be 
always made as a foundation for hydri- 
atic treatment and to determine the ex- 
istence of contraindications for its em- 
ployment. 

The urine should be examined for 
presence or absence of albumin, sugar, 
blood, casts, etc., and for the determina- 
tion of the elimination of nitrogenous 
wastes. 

The blood should be examined to de- 
termine the blood count, and relative 
proportion of red and white cells. 

The temperature should be taken for 
several times successively if possible be- 
fore recommending, or, rather outlining 
the course of treatment. Fever may be 
the result of toxins of bacterial origin, 
as in typhoid; or it may indicate the 
presence of an excess of tissue poisons, 
either from diminished excretion or 
from over-production. 

Nervous symptoms may be either due 
to the presence of nitrogenous waste, 
which is the so-called uric acid diathesis, 
or may be due to some sympathetic irri- 
tation arising from some disease as 
enteroptosis. 

Every case should be examined for 
pathological changes, either structural 
or functional. 

The general physical state of the pa- 
tient must be considered, and also the 
physical aptitudes or temperament. 

In general, the treatments must be 
both palliative and curative. And it is 
a tremendous mistake to direct all the 
treatment to any one circumscribed por- 
tion of the anatomy. Patients, as a rule, 



urge a relief of the symptoms that most 
annoy them. And with patients begin- 
ning treatments of this kind for the first 
time, it is necessary to make an explana- 
tion of some of the apparently aggra- 
vated symptoms that almost invariably 
arise at the first part of the course of 
treatment. 

Dr. Kellogg and a number of other 
experienced hydriatists claim that this 
exaggeration of symptoms, and the oc- 
casional appearance of symptoms quite 
new, are probably due to the intensity 
of the visceral activity, brought about 
by the strong stimulation of the sympa- 
thetic nervous system produced by the 
hydriatic applications. These increases 
in intensity of symptoms do not neces- 
sarily mean that the patient is getting 
worse, or that the treatment does not 
agree with him. 

The patient should be made to under- 
stand that the reorganization of badly 
depressed vital processes will be at best 
a slow matter, and that there may be 
no diminution of chronic symptoms for 
some time. This is always a source of 
discouragement to patients, as is also the 
expense necessary in carrying out any 
protracted treatment. 

However, it is important that patients 
suffering from chronic disease should 
continue treatment until there has been 
a disappearance of the symptoms of his 
disease, and the vital resistance in- 
creased. Chronic disease is never com- 
pletely cured. Though symptoms disap- 
pear, there is the permanent constitu- 
tional weakness, exposing the patient to 
breakdowns of the same sort again. 
Therefore, the best that can be done is 
to supplement these treatments with a 
careful attention to diet, exercise and 
general hygienic measures. 

(To be continued,) 



^natomp anti $|)^0tologp 



The Muscular System 



CLARA BARRUS, M.D. 



(Continued from April.) 



^ I ''HE thumb especially is well sup- 
-■■ plied with muscles, making it pos- 
sible for the human being by means of 
the hand to achieve marvellous and com- 
plicated movements denied to any other 
animal. More than thirty muscles take 
part in moving the fingers alone. These 
hand movements are capable of extraor- 
dinary development in skill and variety, 
and a large part of the wonderful results 
we enjoy in an accomplished pianist or a 
violinist, for example, is due to his cul- 
tivated dexterity of these various mus- 
cles. The arts and crafts owe their 
achievements to the training of the hu- 
man hand as a servant of the intelligent 
brain. This is one of the first and most 
rational steps in a sound education — 
rendering the muscles obedient to the 
ideas conceived by the mind. In this we 
get a hint as to how best to restore cer- 
tain abnormally working minds to more 
nearly moral activity — ^by teaching pa- 
tients to do things, to make their mus- 
cles subservient, first to the simpler 
movements, in obedience to the will, and 
then, by easy stages, to go from the 
simple to the more complicated move- 
ments. 

In a general way the muscles of the 
lower extremity correspond to those of 
the upper. There are those in the iliac 
region, seen in the abdomen after the 
removal of the organs, that are con- 
cerned in bending the thigh on the pelvis, 
in helping support the spine, and in ac- 
complishing the various movements of 
the loins. Then there are the large mus- 



les of the thigh that aid in maintaining 
the upright position and in moving the 
thigh and leg in the various directions; 
and those of the leg and the foot that 
supplement these and enable us to per- 
form all the varied acts of standing, 
walking, sitting, bending, kneeling, kick- 
ing, dancing, etc. In the lower ex- 
tremity, however, the position of the ex- 
tensors and flexors is reversed, the ex- 
tensors being on the anterior surface and 
the flexors on the posterior surface. 

The sartorius, or tailor's muscle, the 
largest one in the body, crosses the thigh 
diagonally from the hip to the inner side 
of the knee. Its inner border forms the 
chief guide to the surgeon in tying the 
large artery of the thigh. It is the mus- 
cle used in crossing one thigh over the 
other. The large four-headed muscle 
called the quadriceps extensor, is the one 
that forms the fleshy mass of the thigh 
anteriorly, . and its four parts unite in 
forming the tendon that encloses the 
patella — the part that we tap in testing 
the activity of the knee jerks when ex- 
amining the patellar reflexes. There is 
a biceps in the lower extremity also, but 
this being a flexor, is on the posterior 
part of the thigh. The gluteal muscles 
make up a large part of the hips, to- 
gether with a large mass of adipose tis- 
sue they form the prominence of the 
buttocks, the fleshy cushions on which 
the body rests in sitting. 

The chief muscles on the back of the 
leg are named the gastrocnemius and the 
soleus, the former making up the chief 



22 



THE TRAINED NURSE AND HOSPITAL REVIEW 



part of the calf, and the latter 'being just 
beneath it. Together they form the 
biggest tendon in the body, called the 
tendo Achilles, which is about six inches 
long and extends from the middle of the 
leg to the heel bone. This tendon is 
named after the Greek hero, Achilles; 
the tradition being that his mother in 
his infancy dipped him in the river Styx 
to render him invulnerable, but because 
she held him by the heel, thus preventing 
that part from getting wet, this point 
was his one weak one, and here in later 
years he received his death wound. 

The foot is, of course, more restricted 
in motion than the hand; but twenty 
muscles take part in moving the toes, 
and it is very probable that were we to 
exercise and train the muscles of the 
toes more, we could attain a much 
greater degree of dexterity than we are 
now capable of; in fact, this has been 
proven again and again by maimed per- 
sons who, deprived of the use of their 
hands, have learned to write, to play the 
piano and to perform other extra- 
ordinary feats with their toes. 

We need to cultivate more respect for 
our muscles; to regard them more as 
useful servants, capable of much better 
work than we assign to them. They do 
the world's work, they build our cities 
and our homes, procure us food, manu- 
facture the things we use, or build and 
set going the machinery to do it ; they de- 
liver the lectures and sermons, write the 
books, sing the songs, bring forth the 
music from the various instruments and 
paint the pictures that we enjoy; they 
form the sounds that make our speech 
that helps us to communicate with one 
another. If they are untrained and un- 
developed, we are undeveloped; if they 
are flabby, our thoughts are likely to get 
flabby and our good intentions to mis- 



carry and fail to become deeds. So that 
body-'building — muscle building — is real- 
ly brain building and character building. 
By our muscles, not of the face alone, 
but of the entire body, we express the 
thoughts we habitually harbor. If we 
fail to train the muscles, they some- 
times get the upper hand and not only 
govern but also betray us, revealing 
things we would far rather keep con- 
cealed. 

In connection with the thought of 
muscular training as a means of express- 
ing and governing the emotions, we are 
led to consider the curious interrelation 
w'hich exists between cause and effect, 
and effect and cause. Those who have 
studied expression most say that by as- 
suming certain expressions of face and 
certain postures of body that have been 
found usually to be the natural result 
of certain feelings, we can induce those 
feelings when they do not exist in us. 
For example, if we feel dumpy and dis- 
consolate and let our mouths droop and 
our shoulders too, and sit humped over, 
brooding on the things that depress us, 
we foster the feelings already controlling 
us, but if we begin to act a little, put on 
a cheerful expression as a garment, 
throw our chests out, walk off with a 
sprightly step, and try to make other 
people think we never felt better in our 
lives, it is an actual fact that we can not 
only fool other people into thinking we 
are cheerful, but we can also fool our- 
selves into getting almost cheerful, if not 
quite so. Hence, it is permissible to as- 
sume a virtue (in muscular action) if 
you have it not. In a lesser way you 
can test this thing by imitating another's 
gait and manner. Walk behind a 
"chesty," self-important person, trying 
to walk as he does, and see how quickly 
you can induce in yourself a temporary 



ANATOMY AND PHYSIOLOGY 



23 



feeling of exaggerated self-esteem, then 
imagine how easy it would be to make 
this temporary feeling more and more 
persistent if the ''chesty'* attitude should 
become second nature. Shrink from 
cold and contract your chest and see how 
quickly you shiver and feel colder and 
colder; stretch and yawn and feign 
sleepiness and watch yourself getting 
really sleepy; sigh and groan long 
enough and you can deepen a sadness 
and discomfort that could often be dis- 
pelled 'by an opposite course of conduct ; 
dance and sing and the mirth you teach 
your muscles to simulate will often ac- 
tually come in place of its counterfeit. 

This, then, gives us a hint in directing 
the postures and habits of the patients, 
as well as in our own self-discipline. 
But be careful how you tell a patient in 
so many words to "cheer up." Rather 
make him forget that he needs to cheer 
up, and by dint of some surprise or 
diversion or subterfuge get him, even for 
a short time, to assume the expansive at- 
titudes instead of the depressed ones ; to 
cultivate the extensors, if the flexors are 
over-developed, and so, by degrees, to 
overcome the undesirable expressions 
and attitudes by substitution. 

As skill, endurance and perseverance 
are the fruits of well-trained muscles, so 
fatigue, restlessness, forcelessness, lack 
of control and of poise are the result of 
our failure to require our muscles to 
perform purposeful acts. We need to 
consider carefully this truth in its prac- 
tical application. Children and patients 
given to choreic movements, to tics, 
fidgets and the like, need judicious mus- 
cular training, but they should not be put 
at work requiring the use of the finger 
muscles that demand skill and exactness, 
but rather to the exercise of coarser 
muscular movements, so to counteract 



these tendencies and bring the entire 
body into harmonious action. 

The motor restlessness that shows it- 
self in automatic muscular mannerisms 
common in nervous children, and es- 
pecially prevalent in certain disease 
types (such is licking things, clucking, 
grinding the teeth, scratching, tapping, 
twirling or chewing the hair, or pulling 
it out, biting the nails, shrugging the 
shoulders, raising the eyebrows, moving 
the ears, pulling at buttons, twiddling the 
thumbs, nodding the head, squinting, 
winking and blinking, swaying, grimac- 
ing, scraping the floor, picking the face, 
sniffling, crackling the joints, nibbling 
and sucking things, trotting the leg, and 
still others not named) are all express- 
ions of fatigue, due to overstimulation 
of the nervous system, resulting in nerve 
strain and to under-stimulation of the 
larger free harmonious muscular activity 
that would do much to correct and re- 
move these bad habits. By coarser mus- 
cular work I mean the exercises of the 
legs, back, shoulders, chest and arms — 
climbing, lifting, dragging, carrying, etc. 
The almost ceaseless activity of a wide- 
awake healthy baby, the play of chil- 
dren and the athletic games of adoles- 
cence are all nature's means for train- 
ing the coarser musclar movements, 
while the finer muscle training in the 
young begins in kindergarten work, later 
in writing their school exercises, and still 
later, as education progresses, in draw- 
ing, piano practise, in the pronunciation 
of words in a foreign tongue, in singing, 
dancing, acting and the like. And the 
same steps that educators use can be 
used by you on the wards in training 
your patients to get control of their vari- 
ous muscles, for the patient's good chiefly, 
as I have said elsewhere, and only sec- 
ondarily to obtain the product of their 




24 



THE TRAINED NURSE AND HOSPITAL REVIEW 



work. In the talks on the occupation 
and amusemenf of patients, I have tried 
to suggest various expedients for accom- 
plishing this muscular training, but a few 
simple things may properly be men- 
tioned here. 

If you have no apparatus for exercise, 
you are by no means hampered in this 
work — walking is one of the very best 
means of general exercise for the ma- 
jority of patients, and few there be who 
get enough of it. If they can walk in 
the open air, so much the better, if not, 
on the hall or balconies is better than 
not to walk at all. Walking backward 
is excellent practise, and some patients 
can be induced to do this, it being some- 
thing out of the ordinary, just to show 
their ability over that of some one else, 
when they would not do it for another 
motive. Sometimes fidgety ones can be 
cajoled into trying to sit perfectly still 
for a half minute, gradually extending 
the time, bringing this about in a play- 
ful way ; others can be persuaded to spin 
a top, to stand or walk on one foot, to 
rise on first the heels and then the toes, 
to practise arm movements — simple 
things, but not to be set aside as un- 
worthy of your attention and trial. And 
best of all it is to get the patients to do 
things that they can develop a real in- 
terest in, especially if the work admits of 
progress, and of some real constructive 
ability on their part. 

But in enjoining work we must not 
forget play which is quite as essential 
to the well being as work itself, even to 
persons who have passed the period of 



childhood. Games and sports, gymnas- 
tic exercises and so on, come in this cate- 
gory, but, like everything else, certain 
sports and gymnasium practises are ca- 
pable of abuse, and by over-development 
of certain parts at the expense of others, 
we see "muscle-bound" gymnasts, over- 
taxed hearts and other results of inju- 
dicious methods. It will be a long time, 
however, before one will need to cau- 
tion you as nurses against the over- 
exercise of your patients, except in a few 
isolated cases; one rather needs to re- 
mind you of the necessity for resorting 
to all the legitimate means you can de- 
vise to get your patients to take sufficient 
exercise for their muscular well being. 
In this connection I will conclude this 
talk by reminding you of that old East- 
ern allegory of the wise dervish, who 
knew that all mankind, as a rule, need to 
be cheated into doing what is best for 
them. His ailing and lazy Sultan came 
to him for medical advice. He knew 
that candor would not be appreciated, so 
he said to his royal patient: "Your 
Highness, I have saturated this bat and 
ball with costly and efficacious medicinal 
herbs that are needed for your cure. 
Knock the bat and ball about every day 
until you perspire freely, and thus ab- 
sorb the medicines in them through your 
pores, and Your Highness will be cured 
of this malady." The Sultan did as he 
was told. He was cured; but the cure 
was effected, not by the absorption of 
medicines, for there were none — the wily 
dervish having deceived the Sultan on 
this point — ^but by the simple means of 
needed exercise. 



3^tti)tn ti)e Colodsal i^utt Cafife* Cliere 



CHRISTIK M. WILLIAMS. 



T DARE say that no one thing plays so 
^ great a part in the life of the trained 
nurse as her suit case. One frequently 
hears of the traveler touring the Con- 
tinent with only a suit case as baggage. 
The traveler that goes in this way wears 
a tailored suit, carries the necessary toilet 
articles, a change of underclothing and a 
few waists, usually silk or something 
that "does not have to be laundried. 

The nurse must carry enough wash 
dresses to last an indefinite length of 
time. She must go prepared to meet 
every emergency. There is no doubt 
that it is an art to live comfortably in a 
suit case. If managed well it can be 
done. First of all, select the case with 
the greatest capacity and least weight. 
Leather is entirely too heavy — the light 
wicker or masche are far more sensible, 
they weighing about one-half as much tis 
leather, are cheaper, and quite as dura- 
ble. It is well to have two, one kept 
for clothing, the other for sterile dress- 
ings. 

It is inconceivable that so many 
articles can be packed in one small 
compartment; it is quite possible if 
everything is purchased with regard to 
bulk. For instance, the uniform of white 
— and almost every graduate nurse wears 
white these days — can be of long cloth 
or a light weight linen, and for a change 
in Summer a pretty dimity of some kind, 
instead of the heavy shrunk cotton that 
so many nurses wear. The night- 
gowns should be of the soft French 
variety; the kimono of thin wash ma- 
terial for Summer and some washable 
flannel or outing flannel in Winter. A 



very nice kimono is made of umbrella 
silk. It is soft, washable, and comes in 
a variety of pretty colors. It is im- 
perative that everything be as light and 
small as possible. 

The case should be packed with the 
greatest care. The nurse should be 
able to go to her suit case any time, 
day or night, and lay her hand on 
anything she wants, without scratching 
and scrambling through, as I have known 
some to do. The luxury of a dresser 
drawer or two is not provided in every 
family — so learn to keep things in order 
without it. 

Things that are used the least are 
packed in the bottom; stockings, collars, 
handkerchiefs, all have their own sep- 
arate corner, and are always kept there. 
It saves time both in packing and un- 
packing if you have a regular system. 
For instance, if hypodermic and tablets 
are always kept in their places, and 
wanted in a great hurry, one can find 
them in the dark. It is nice if one can 
have a fitted toilet case; that takes a 
great many little things out of the large 
case that have a faculty of losing them- 
selves, unless great care is taken. A 
great help to the nurse who often has to 
pack in the quickest possible time is to 
have a standard list for the average case 
neatly printed and pasted on the inside 
of the cover. This saves time and re- 
moves the chance of possibly forgetting 
some very important and much-needed 
article, if one but casts an eye down the 
list. One list contains the following; 

Three caps, five uniforms, two belts, 
six collars (aprons?), three corset cov- 



26 



THE TRAINED NURSE AND HOSPITAL REVIEW 



ers, three suits underwear, four pairs 
stockings, three nightgowns, slippers, 
kimono or night uniform, handkerchiefs, 
toilet napkins, comb and brush, tooth 
brush, dentifrice, wash cloth, towels, 
soap, laundry bag, nail file, button hook, 
pencil, fountain pen, stationery and 
stamps. 

"Housewife" — Thread, thimble, scis- 
sors, buttons, darning cotton, pins, hooks 
and eyes. 

Tablet of chart paper, hypodermics 
and case, thermometers (clinical and 
bath), strychnine, gr. 1-30; morphine, 
gr. J^; atropine, gr. i-ioo; nitro glycer- 
ine, gr. i-ioo; digitalis, gr. i-ioo; apha 
morphia; glass douche tip, glass enema 
tip, glass catheter, rubber catheter, high 
rectal tube, irrigating tips, hot water 
bag, hand brush, antiseptic tablets, rub- 
ber gloves, scissors, hemostat, linen 
tape. 

On the cover of the "Sterile Suit Case" 
is printed three lists: Obstetrical, major 
operations, minor operations. The ob- 
stetrical contains: 

Three sheets, two doctor's gowns, one 
nurse's gown, one package cotton, three 
packages vaginal pads, eight to twelve 
towels, patient's gown and stockings, 
two packages small sponges, one pack- 
age large sponges, one package cotton 
balls (for babe's eyes and mouth), um- 
bilical dressing. 

The operative packages are seldom 
used by the private nurse, and these can 
be procured from the hospital. The ob- 
stetrical must be prepared again and 
again by the average nurse. A good way 
to do is to go to the patient's home, make 
pads, cotton balls, sponges, etc., having 
first given the patient a list for supplies ; 
put all in packages, pack in suit case and 
send to hospital for sterilization — home 
sterilization, at best, being very risky. 

When called to a contagious case, the 
contents of the suit case may be trans- 
ferred to two suit boxes that can be 



burned when the nurse is released from 
quarantine. Suit boxes should always be 
kept on hand for this purpose. Take 
only things that can be boiled or thor- 
oughly disinfected. Call a carriage and 
go in uniform, without coat or hat. If 
too cold to go without, wear and send 
back by driver. A good way to do is to 
save old shoes for such cases, that can 
be burned; those with rubber heels can 
be worn at night instead of contaminat- 
ing bed slippers. Upon leaving the case 
all laundry is thoroughly disinfected and 
sent to the laundry, the man instructed 
to deliver same to nurse's home. Take 
an antiseptic bath and shampoo. Of 
course everything has been disinfected 
and fumigated when the quarantine is 
raised. Upon reaching home a second 
bath is taken, clothing soaked in formal- 
dehyde before sending to be laundried; 
shoes and suit boxes burned, instruments 
boiled. The nurse has then done her 
duty to prevent the disease from spread- 
ing. 

Do nurses realise the importance of 
being zvell dressed? Being well dressed 
does not necessarily mean in the height 
of fashion or following the latest fad. 
It means neatly and simply. Neatly and 
simply means tailored. Let every one re- 
member "to put the best foot forward 
always !" 

"First impressions are the most last- 
ing." Therefore, let each one present 
the most immaculate and well groomed 
appearance possible at all times. The 
woman who wears a badly fitting suit or 
uniform hasn't the confidence or self- 
respect, and, therefore, does not inspire 
it in others. The scientifically packed 
suit case and, as nearly as possible, the 
perfectly gowned nurse should go hand 
in hand. 



C|)e IBitt iUtcten 



Food and lt5 Use 



ROSAMOND LAMPMAN. 



T^ XTRACTIVES, or the flavoring 
^-^ principle of meat and other foods, 
are included with the protein compounds 
because of the nitrogen they contain. 
They are the chief ingredients of all 
meat extracts — ^beef tea, etc. — and are 
usually classed as stimulants and appe- 
tizers. 

Fats are derived principally from ani- 
mal foods, as meat, butter, cream, milk, 
fish, etc.; also certain vegetables and 
cereals, as olives, olive oil, oatmeal, 
maize, and some varieties of nuts. Fats 
are used in the body to form fatty tissue 
and to nourish the nerves and other tis- 
sues. They are the chief fuel ingredients 
of our food; they serve to maintain the 
animal temperature of the body, and 
yield energy in the form of muscular 
and other powers needed for its work. 

It is said that one-fifth of the body 
weight is composed of fat, but the 
amount of fat taken in the body varies 
under certain conditions, as the quantity 
of fattening foods eaten, exercise, age, 
etc. Starches and sugars of food are 
changed to fat in the body and stored 
as such, the body thus forming a supply 
of fuel, kept in reserve, to be utilized 
when there is a deficiency of fat in any 
of the constituents of food. 

Sugar is principally of vegetable origin, 
of which there are many kinds. That 
which we use most commonly in our food 
is cane sugar, or sucrose, obtained from 



the juice of sugar cane, beets, maple-tree 
sap and other vegetable growths. Be- 
sides cane sugar, there ire a number of 
sugars, as grape sugar or glucose, milk 
sugar or lactose, fruit sugar or levulose 
(diabetin), malt or lactose, honey, etc. 

Glucose, or grape sugar, is one of the 
varieties of sugar which exist in large 
quantity in peaches, pineapples, straw- 
berries, grapes and other fruits. Glucose 
is commonly manufactured from starch ; 
it is more readily absorbed in digestion 
than is cane sugar; it also undergoes 
fermentation more readily and is apt to 
produce flatulent dyspepsia. It has less 
strength of sweetness than cane sugar, 
and is often used as a substitute 
for the syrups of commerce. Confec- 
tioners use it in making "fondant," or 
the soft fillings used for bon-bons, etc. 

Lactose, or milk sugar, is taken as a 
food in some quantity with milk, and 
forms a very important element in this 
form of diet for infants or patients with 
weak digestion. It is less liable to pro- 
duce acid fermentation than cane sugar. 
That of commerce is principally manu- 
factured in Switzerland. 

Levulose, or diabetin, is a fruit sugar 
in crystallized form. It is sweeter than 
cane sugar and has a somewhat fruity 
taste. It is said that diabetic patients can 
use it in considerable amounts without it 
reappearing again in the urine or dis- 
turbing digestion. 



28 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Starch, the most widely distributed of 
the vegetable principles and the chief 
source of the carbohydrates, is an easily 
digested form of vegetable food when 
properly cooked, though not as available 
for the repair and growth of the tissues 
as fats ; yet, by its oxidation it saves tis- 
sue waste, and, like sugar, furnishes both 
heat and muscle force. 

Starch, when presented to the naked 
eye, has the appearance of a white pow- 
der, but when examined under the micro- 
scope it is seen to consist of transparent 
oval granules of a somewhat uniform 
structure. 

These small granules will not dissolve 
in cold water, but when cooked in boiling 
water they swell and burst open, and are 
then easily dissolved. 

Starch forms the principal part of 
every day diet. It is found in nearly all 
breadstuffs; wheat, corn and rye flours 
are more than one-half starch. Rice, 
which is "the staff of life" in the "Far 
East," contains eighty per cent; in the 
common potato each cell is completely 
filled and distended with the accumula- 
tion of starch and water. The greater 
part of cornstarch, sago, arrowroot, 
tapioca, peas, beans, turnips and carrots 
consists of starch. 

In the case of patients with weak di- 
gestion, all starchy foods, as cereals, etc.. 
should be partially dextrinized, arti- 
ficially, or by long cooking, at a tem- 
perature which will change the starch to 
such an extent that it may be easily con- 
verted into dextrine and then into glu- 
cose by the digestive fluids. 

The mineral salts are as essential for 
the perfect building of our bodies as any 



of the other elements. They are mingled 
with all food materials in more or less 
quantity and are distributed through all 
parts of the body, in the blood, tissues, 
brain, bone and other organs. Like the 
other food elements, they are constantly 
being consumed and eliminated; there- 
fore, they must be continually replaced 
by means of food. Fresh vegetables and 
fruits are particularly valuable as food 
because of these salts ; whole wheat flour, 
barley, oats and rye are rich in mineral 
salts, the most important of them being 
phosphate of lime, which enters so large- 
ly into the structure of the bones and 
teeth. It is not thought that mineral 
matters are changed by digestion. 

Water, one of the most important arti- 
cles of diet, is a compound of oxygen 
and hydrogen, although it undergoes no 
change in the body ; yet, it enters largely 
into the chemical composition of all its 
organic matters. It forms the principal 
ingredient of the fluids in the body and 
gives to them the power of holding a 
great variety of substances in solution. 
In this way new supplies are conveyed 
to the points where they are required. 
At the same time it acts as a solvent to 
wash out materials from the system 
whenever it is needed. 

It is said that water constitutes by 
weight not less than sixty per cent of the 
average human body. It is introduced 
into the system with all kinds of food, 
and is the basis of almost all drinks. It is 
therefore very important that the water 
we drink or use in the preparation of all 
food should be as pure as possible, and 
if there is any doubt of its purity it 
should be filtered and sterilized. 



€trttortaUp ^peaktns 



A Training Problem 

For some years the predominance of 
surgical work that finds its way to hos- 
pitals, the predominance of facilities for 
surgical work and the lack of facilities for 
treating medical patients according to the 
best known modem methods has been 
the cause of more or less desultory com- 
ment. How serious the training aspect 
of this condition is has received scant 
attention. Yet, to our minds, it is one of 
the most serious phases of the training 
and nursing situation. Every private 
nurse except those few who specializr^ 
along a certain line, or who get the ma- 
jority of their calls from hospitals for 
"special nursing" of private patients, is 
likely to tell you that she gets very few 
calls to surgical patients in their homes. 
The bulk of her work is likely to be med- 
ical cases. Yet the waning facilities for 
giving training and experience in medical 
nursing in hospitals is seldom mentioned. 
A large number of so-called "general 
hospitals" are practically surgical hos- 
pitals. One instance will illustrate. A 
certain man who was considering leaving 
a bequest to a hospital or to hospitals 
that met his idea of what a general hos- 
pital should be in regard to business man- 
agement, dissemination of knowledge 
tending to better care in sickness and 
through proper training of doctors and 
nurses, inspected or investigated a well- 
known high-grade so-called "general" 
hospital of about 175 beds. The training 
school numbers about 75 nurses. At the 
time of his visit there were exactly seven 
medical patients in the hospital, and out 



of over two hundred patients enrolled In 
the last month or so, there were but ten 
medical patients. This is an illustration 
of a condition that could be duplicated 
many hundreds of times in the United 
States, and it certainly would seem to 
call for serious consideration on the part 
of those who are desirous of improving 
nurses and nursing. Most of the nurses 
graduated go directly into private work 
after graduation. They are trained, 
highly trained, as surgical nurses, but 
many very poorly trained as medical 
nurses. Yet their future work as private 
nurses or as visiting nurses must largely 
be among medical patients. Graduates 
of special hospitals are debarred from 
registering in a number of States, but 
what of the graduates of general hos- 
pitals, so-called, which are in reality sur- 
gical hospitals? To even hint that the 
training of the nurses in such hospitals 
was defective in this important particu- 
lar would be strongly resented, but it ir 
true. This situation only emphasizes 
more strongly the conviction that is 
growing in the minds of many that two 
or three months should be required of 
every pupil nurse, of nursing in private 
homes of people of limited means, or of 
visiting nursing before graduation — this 
not simply to benefit the limited means 
patient, but to round out the training, 
which the changed character of hospital 
work renders necessary. 

If medical patients can be comfortably 
and successfully cared for at home there 
is surely no strong reason for taking 
them out of their homes, except when 



30 



THE TRAINED NURSE AND HOSPITAL REVIEW 



the illness would endanger the people of 
the immediate neighborhood. If the 
nurse cannot get the training in medical 
nursing which she needs (and she cer- 
tainly cannot in a great many hospitals) 
there is no good reason why she should 
not be allowed to secure the necessary 
experience under proper restriction and 
supervision in homes in the community, 
providing, that in getting the experience 
she did not encroach on the province of 
the graduate nurse — that is, that such 
nursing be confined to people who could 
not in any case pay the cost of the 

graduate. 

+ 

The Fourth of July Sacrifice 

For seven years the Journal of the 
American Medical Association has been 
collecting statistics regarding the annual 
death rate and injury involved in our 
method of celebrating our national fioli- 
day. The public is slowly awakening to 
the folly of the sacrifice, and several 
cities have taken a vigorous stand 
against the practice of selling explosives 
recklessly to any who choose to ask for 
them. A number of the popular maga- 
zines have taken part in the campaign 
for a "safe and sane Fourth." 

One of the most vigorous arraign- 
ments of the foolish methods which have 
been customary was contained in Popu- 
lar Mechanics for March, 1910. It calls 
attention to the "coming sacrifice" and 
states that "for scores of healthy happy 
boys and girls the days of life are nearly 
ended." It pictures in a striking manner 
the results of a vote by Congress, if that 
were possible, to sacrifice one unknown 
boy each year as a national Fourth of 
July oflFering, the extra editions of news- 
papers announcing this extraordinary 
action, the editorial denunciation of the 
lawmakers, the public agitation and ex- 



citement, the petitions to Congress and 
the President, and the Civil War that 
would surely follow an attempt to exe- 
cute that decree. "Such an attempted 
sacrifice," says the J. of A. M. A., "of 
course is an impossible one, but if it 
could be seriously suggested for a mo- 
ment, the pictured results would be true 
in every detail. All this would occur 
over the contemplated sacrifice of one 
unknown boy; and yet, we supinely al- 
low, year after year, the slaughter of 
hundreds and the mutilation of thou- 
sands, causing desolation and anguish in 
many homes." 

This is one reform into which every 
intelligent citizen can enter heartily. 
Apart entirely from the serious physical 
risks involved, the racket and noise con- 
tinued hour after hour, sometimes for 
the larger part of three days, have made 
it a day to be dreaded. Nurses who have 
come into immediate contact with 
Fourth of July results should be espec- 
ially interested in any method of re- 
forming the day, and all nurses who are 
lovers of humanity can add their voices 
to the general volume of protest against 
the insane customs which have been per- 
mitted to mar our Independence Day. 

+ 

The Widening: Field for Nurses 

As knowledge increases and civiliza- 
tion advances the opportunities of the 
nurse widen. One of the possibilities for 
nurses who have a gift for public speak- 
ing and a liking for change of scene is 
that afforded by the farming organiza- 
tions known as "The Grange" and "The 
Farmers' Club," one or both of which 
are likely to be found in practically all 
of the States. These organizations are to 
the farmer, his wife, family and em- 
ployes, what the nurses' associations are 
to nurses — that and more. They have 



EDITORIALLY SPEAKING 



31 



become the centre of social life in vari- 
ous communities, and rej)resent the pro- 
gressive and most intelligent part of 
rural life. There is a State association, 
a county branch and numerous local 
branches. The local branches hold 
monthly or semi-monthly meetings, at 
which all sorts of subjects relating to 
the farm and the farm home are dis- 
cussed. State meetings are held once or 
twice yearly, at which the attendance of 
delegates sometimes numbers thousands. 
"State lecturers" are employed, who 
travel from county to county, and to 
local meetings, according to a schedule 
arranged by the general officers. In some 
States the expense of these lecturers is 
borne in part by the State. There are 
now a number of nurses employed as 
State lecturers, and a much greater de- 
mand for nurses to undertake this form 
of work is going to be felt before many 
years. They lecture on such subjects as 
home sanitation, the care of babies and 
children, tuberculosis and its prevention, 
diet and health, accidents and emergen- 
cies in the home, etc. Demonstrations in 
the line of bed-making and how to give 
the simple nursing treatments in the 
home are often given. 

There are many nurses who have had 
years of experience in lecturing and 
teaching nurses who are well fitted by 
natural endowment to undertake this 
form of work. The opening wedge to 
this new door of service may come in an 
invitation to address some small local 
group of rural dwellers. It may seem a 
very small sized opportunity and its re- 
semblance to a wedge may not be no- 
ticed, nevertheless such opportunities are 
often wedges. 

The nurse who has a fondness for 
rural life and a longing for a "bit of 
God's earth all her own" which she may 



cultivate may find it possible to secure 
an opening as a lecturer that will be 
profitable for the Winter months, leaving 
her free to develop her farming and gar- 
dening propensities in the Summer. The 
State colleges of agriculture can usually 
give information as to the officers of the 
associations one should apply to for a 
position as lecturer, and if a short course 
in the agricultural college can be taken 
it will prove a wonderful help in getting 
in closer touch with the people. In many 
State colleges several short courses of a 
month to six or eight weeks are offered. 



The Personality of the Teacher 

From the beginning of trained nurs- 
ing emphasis has been placed on the 
personal equation as an important ele- 
ment of success in practical bedside 
nursing. As our appreciation increases 
of the innumerable and subtle ways by 
which one mind, unconsciously or other- 
wise, influences pther minds, we are 
placing more and more value on the per- 
sonal make-up of the nurse, her adapt- 
ability or inadaptability to a given case 
and the effect her personality is likely 
to have on the patient to be nursed. 

We have, however, placed less em- 
phasis on the personality of the teacher 
as an important element of success in 
training-school work. We have consid- 
ered the school in which she was trained, 
her standing in her classes, etc.; we 
have harped on the number of beds "al- 
ways occupied;" made a great point of 
the number of medical men on the 
faculty, and have been very much given 
to overlooking the importance of the 
personal attitude of the person at the 
head of the training school to the whole 
problem of nurses and their training. If 
the woman at the head of the school re- 



32 



THE TRAINED NURSE AND HOSPITAL REVIEW 



gards classes as of minor importance, to 
be skipped when there is any pretext 
for so doing; if she regards nurses as 
convenient, even necessary agents for 
getting so much work done, and cares 
little how much or how little they learn 
or fail to learn as the months go by; if 
she thinks and says that teaching is a 
bother, that she hates it, etc., it is hardly 
to be expected that the nurses "trained" 
by her will excel. If they do it will be 
in spite of her, rather than because of 
her influence. This phase of the train- 
ing question was brought out at a re- 
cent meeting of the New England As- 
sociation for the Education of Nurses 
by Dr. Richard Cabot, and his remarks 
are well worth considering. Dr. Cabot 
says: "A matter which I think needs 
to be considered from time to time, 
whenever we are considering the subject 
of teaching, whoever is being taught, 
whatever is the subject of the teaching, 
is the teacher. That is the thing which 
makes 75 per cent, of the difference. It 
isn't the curriculum or anything that 
can be set down on paper, but it is the 
personality of the teacher. I don't know 
where that seems more important than 
in the training school. I believe the 
best training schools to be those in 
which the nurse comes in closest con- 
tact either with nurses or with physi- 
cians whom they will admire in future 
years. I was talking with Professor 
Hausman, of the Harvard Medical 
School, about some of our classes in the 
medical school, and we agreed that the 
fundamental trouble with most of the 



teachers was that they didn't really love 
human beings. He agreed with me, or, 
rather, I agreed with him that the first 
essential for a person who was to be 
a teacher of anything is that he should 
really love human beings and desire to 
communicate knowledge as a means for 
the expression of his affection." 

We are hoping to see the day when 
there will be a place in every city for 
at least a few nurse teachers, who, hav- 
ing had experience in hospital schools, 
and have developed an enthusiasm for 
the teaching of nurses, can devote their 
efforts entirely to this work, being paid 
by the hospitals for a certain number of 
hours of class work each week. This 
would relieve the often overburdened 
principal of the school, or superintend- 
ent, and leave her free to spend more 
time in bedside supervision and instruc- 
tion; it would do away with much hap- 
hazard work in training schools, and the 
nurses who really loved teaching, who 
really loved nurses, would be the ones 
most likely to consider this as a special 
line of work. Such a nurse would have 
an added incentive to study the methods 
of the best teachers, and the results 
should be gratifying to all concerned. 
The personality of the medical instruc- 
tors is quite as important. Many, per- 
haps most, of the best lessons are learned 
outside of the class room through inci- 
dental informal personal contact at the 
bedside or in the operating room before 
or after the operation, with a doctor who 
had an ambition to use such opportuni- 
ties to add to the nurse's knowledge. 



Owing to the length of the reports of the national societies, it has been neces- 
sary to omit much interesting nezvs matter, which, hozvez'er, will appear without 
fail in the August issue. 



Ctie Ifbo^piM l^etitetD 



The Revival of an Old Problem. 

Hospital problems, like history, have a 
habit of repeating themselves, and every now 
and then the old familiar problem of the ex- 
tent to which nurses should be required to give 
nursing care to male patients in a hospital 
bobs up in some new quarter. More than 
one institution has been torn with dissension 
over this same old problem. It looks as if it 
was time it might be settled for good and all. 
This time it is the Grady Hospital, Atlanta, 
which has been exercised to a serious degree 
over the matter. Conflicting accounts have 
reached us, but it appears that mixed up with 
the problem is another growing out of the 
division of authority. 

According to the interpretation of the rules 
published over the signatures of the committee 
on medical matters, the medical superintend- 
ent is little more than a purchasing agent. 
The resident physicians or internes have ex- 
clusive control of the admission and medical 
treatment of patients. Complaints from either 
the house staff or nurses regarding patients 
in any way are to be made to the committee 
on medical matters, and not to the superin- 
tendent. Such a condition is certainly unusual, 
and it is little wonder that dissension^ in this 
hospital have been frequent. It is said of the 
present superintendent that since he assumed 
charge, a year ago, expenses have been re- 
duced, while the general efficiency of the ser- 
vice has been increased. More has been done 
for the patients than ever before on less 
money. It is possible, however, to carry the 
cutting down of expense too far, and if, as 
one report stated, the plan is to require 
young women nurses to care for the male 
patients in large charity wards entirely with- 
out the assistance of orderlies or male nurses, 
it is not to be wondered at if there has been 
internal disturbance. Every well-ordered hos- 
pital, however small, has an orderly where 
there are male patients. It is quite true that 
dependence on orderlies by nurses may be and 
has been carried too far, and no nurse with 
good sense will hesitate as to her duty if the 



patient's comfort is concerned and the orderly 
is absent or not to be had at the time. There 
are exceptions to all rules, and the fact that 
nurses have done, and do, such duties in 
emergency is no reason why orderlies should 
be dispensed with. If it was an exception — 
an emergency when the orderly was not avail- 
able and the nurses refused to give the neces- 
sary care — the nurses will surely in the future 
regret their hasty action. If it was intended 
that they should assume the entire nursing 
responsibility for the male patients in a large 
charity hospital, they can hardly be censured 
for rebellion. It is a well-known fact that 
many medical men are notoriously careless 
about exposure of patients, and about the re- 
quirements they make of nurses in such mat- 
ters. In this case it looks as if the committee 
on medical matters had had too much author- 
ity over such matters, and the medical super- 
intendent too little. If the tempest results in 
an overhauling of the rules and regulations it 
will have accomplished some good. 

+ 
Floating Hospital of 3t. John's Guild. 

The "floating hospital" seems to be an 
American creation, and would there were more 
of them to carry on their beneficent work of 
life saving and education for every large city 
located near a large sheet of water. 

.The Floating Hospital of St. John's Guild, 
New York, is about to begin its forty- fourth 
season. Its cost last year for the season be- 
ginning July 6 and ending September 9, in- 
cluding the work of the Seaside Hospital, 
which also was operated as a summer hospital, 
was $81,781.75. The number of women and 
children admitted and treated was 2,696. Of 
these 2,519 were improved or cured. There 
were 51 deaths. 

The Seaside Hospital at New Dorp, Staten 
Island, is to be improved, and plans for a large 
and permanent building are already drawn. 
The cost of this building is estimated at 
$225,000, and it is expected to make of it a 
children's hospital equal to any in the country 
and open all the year. In the Floating Hos- 



34 



THE TRAINED NURSE AND HOSPITAL REVIEW 



pital all classes of diseases except those desig- 
nated as "contagious" are admitted. 

As in other similar organizations, the em- 
phasis is placed on education of the mothers 
with a view to prevention. Besides the gen- 
eral and statistical information, the annual vol- 
ume contains an instructive and most interest- 
ing address on "Infant Mortality" by Dr. 
Abraham Jacobi, president of the Medical 
Board of the Seaside Hospital. 



Motpital of the Good Shepherd. 

At the Hospital of the Good Shepherd, 
Syracuse, N. Y., 2,579 patients were treated 
during the year, at an average cost per day per 
patient of $1.84. A pathological laboratory 
has been established, which has been of great 
value, especially in the surgical division. In 
the training school, by increasing the number 
of pupil nurses it has been possible to do the 
greater part of the special nursing of patients 
by the nurses in training, thus affording 
greater opportunity for special study of cases 
by the pupils, improving the training and in- 
creasing the revenue for the maintenance of 
the school. 

The Training School for Nurses receives 
nurses for special training for short periods 
from Willard State Hospital, Thanksgiving 
Hospital, Cooperstown, N. Y. ; Little Falls 
Hospital, N. Y.; Geneva City Hospital, N. Y. ; 
Broad Street Hospital, Oneida, N. Y., and 
Rome Hospital, N. Y. Miss Ida M. Marker is 
succeeded by Miss Edith W. Seymour in charge 
of the training school. During the year there 
were 201 informal applications to enter the 
school and 65 formal applications of the latter. 
There were 30 accepted, and at the end of the 
year the school had a waiting list of 8. The 
report volume is one of the most concise and 
complete which has come to the reviewer's 
desk for some time. 

+ 

A Hospital Experiment. 

The Chicago Post describes a very inter- 
esting development in hospital economy at the 
Evanston Hospital, Chicago. The superin- 
tendent decided that "broilers" at 97 cents 
each were too expensive for hospital fare, and 
originated the plan of combating high prices 
by starting in the chicken raising business. To 
that end an incubator was secured and early 



in April the first hatch of the season began to 
arrive — sixteen hours before schedule time. A 
fair proportion of the expected 144 chicks are 
already well on the way toward the broths, 
stews and other chicken delicacies which a 
well-ordered hospital delights in supplying to 
its patients. 

+ 

Changes at Wesley Hospital. 

Wesley Hospital, Chicago, is undergoing 
changes which place it in the very front ranks 
of the hospitals of the country. 

A large addition has been erected, contain- 
ing new offices, dining rooms, etc., and fifty- 
four private rooms and suites. The suites 
contain a private bath, with both shower and 
tubbing facilities. The floors are art marble 
throughout and the wood work is mahogany. 
A private telephone and an electric fan is 
part of the equipment of each room. The 
beds are brass and especially designed for 
Wesley Hospital. The Hydrotherapy rooms 
are equiped with facilities for giving electric 
sweat baths, Nauheim baths, shower and 
needle baths and massage. A large solarium 
has been constructed on the roof of the hos- 
pital. This sun parlor contains provision for 
both sexes and has an out-door compartment, 
equipped with a couch swing, rocking chairs, 
lounges, etc.,; also a pergola roof, under 
which patients may get shade and air. The 
solarium makes a splendid lounging place for 
convalescent patients, commanding, as it does, 
a beautiful view of Lake Michigan. 

The operating department is being re- 
modeled. It will contain four operating 
rooms, two anaesthetizing rooms, a surgeon's 
preparation room, a waiting room for the 
friends of the patients, a dressing room, 
sterilizing room and dressings store room. 
These rooms are all on the sixth floor and 
will be furnished with the most improved 
operating-room furniture. 

The obstetrical department contains a prep- 
aration room for the doctor, a preparation 
room for the patient, sterilizing room, two 
confinement rooms and a nursery. Also 
wards and private rooms. 

The children's department contains rooms 
for the segregation of children over ten 
years of age, a room for sick babies, a deten- 
tion room and an isolation room. 

These changes have involved an expense 



THE HOSPITAL REVIEW 



35 



of over $150,000. An "opening" was held 
Saturday, May 7, which was attended by 
about two thousand of Chicago's leading 
citizens. 

+ 
Notes and News. 

Sloane Maternity Hospital, New York, is to 
be enlarged by the addition of an eight-story 
annex. The first floor will contain the offices 
of the superintendent, the gynecologists and 
the laboratories. There will be a two-story 
operating theatre, and a roof pavilion will 
crown the building, which is expected to cost 
$120,000. 



The new maternity ward in connection with 
Heaton Hospital, Montpelier, Vt., has been 
completed. The addition also provides ac- 
commodations for the nursing staff. 



The St. James Hospital and Sanitarium 
Association has been organized at St. James, 
Minnesota. The Park Hotel property has 
been bought and fitted up for hospital uses. 
Dr. C. C. Mauger is in charge. 



A new home is to be built for the nurses of 
Harriot Hospital, Erie, Pa. 



The Methodist Deaconess' Hospital Asso- 
ciation at Peoria is to have a new $50,000 
building. 



The city of St. Louis is to have a hospital 
department organized entirely separate from 
the Health Department. It is hoped in making 
this change to terminate political control of 
hospitals and attract to the institution a higher 
class of physicians than it has been possible 
to secure under* former conditions. 



Mrs. Wallace Martin has been appointed to 
succeed Mrs. Anna Farnham at the hospital 
for soldiers at Grand Haven, Mich. 



A new hospital to be known as St Mary's 
General Hospital is to be built on the north 
side of Pittsburg. 



Anniston, Alabama, through the generosity 
of the late L. H. Kaplan, is to have a free 
public hospital. 



The King's Daughters, of Middlesboro, Ken- 
tucky, have purchased the Elks Home and will 
start a hospital. 



The Chicago Hospital Day Association has 
been incorporated. The object is to promote 
systematic charitable giving for the support 
of hospitals in Cook County working under 
church auspices. Methodists, Baptists, Roman 
Catholics and Presbyterians have thus far 
taken out memberships. Seventy-five women 
from each church constitute the active mem- 
bers. An advisory board of business men is 
provided for. The working plans are similar 
to those of the New York Hospital Saturday 
and Sunday, and the receipts are divided in 
proportion to the free work done. 



Mr. George W. Watts, the millionaire phil- 
anthropist, of Durham, N. C, will erect a 
$50,000 annex to the Watts Hospital, which 
he recently presented to the city. A nurses' 
home is also to be built, which will bring his 
gifts up to the half million mark. The hos- 
pital is said to be the finest in the South. 



The new $7S,ooo addition to Bethesda Hos- 
pital, St Paul, Minn., is ready for occupancy. 
It will increase the capacity of the institu- 
tion to 125. 



Mr. George Eastman, of Rochester, N. Y., 
will erect a $54,000 home for nurses in con- 
nection with the Homeopathic Hospital of that 
city. It will provide for 75 nurses. 



During the past year 528 patients were 
treated at the Margaret Pillsbury Hospital, N. 
H. Miss Hall is the efficient superintendent 
of both hospital and school. 



The new home for nurses in connection 
with the Toronto Hospital for Incurables was 
opened recently with appropriate functions. 
Their Excellencies, Earl and Countess Grey, 
were present, and the Governor-General con- 
gratulated the management and the city on 
the growth and expansion of the institution. 
The present capacity of the hospital is 140 
and a new wing providing for ninety addi- 
tional beds is nearing completion. 



3fh tfie Cmmmg: 



CONDUCTED BY CHARLOTTE A. AIKENS. 




How to Teach Materia Medica 

MINNIE GOODNOW. 
Superintendent Bronson Hospital, Kalamazoo, Mich. 



Materia Medica is undoubtedly the most 
difficult subject in the nurse's curriculum. It 
consists of a mass of unconnected details, 
a collection of unrelated facts, hard to learn 
and still harder to retain. The average nurse 
learns little of the subject except what she 
acquires in her experience of giving drugs 
to patients. Few doctors take the trouble to 
tell a nurse why they are giving a certain 
medicine, and some even omit to tell her 
what they are giving. She does not know 
what to look for, therefore never sees it, 
and the effects of drugs remain an unknown 
quantity. She may know, for example, that 
one-one hundredth of digitalin was ordered, 
that she gave it, and that the patient's pulse 
was somewhat better afterward. Very crude 
and elementary knowledge this. 

Faulty methods in teaching are responsible 
for this state of things. Incompetent teachers 
make our nurses stupid in matters about- 
which they should be keen, and bored by a 
study which should be a fascinating one. 

First, as to the teacher. Usually it should 
be the superintendent of nurses. Doctors, 
of course, know far more materia medica 
than she does, but that is no proof that they 
can teach it. As a matter of fact, if one 
is to julge by results, they teach it very 
badly. If an interne or young practitioner 
can be found to whom the needs may be 
explained, who will take pains to help his 
pupils to learn and who will not think it 
beneath his dignity to use simple methods, 
you may have it taught by a doctor; not 
otherwise. Most doctors' classes in this sub- 
ject are more or less failures and rather 
disheartening. 

Above all, remember that Materia Medica 
cannot be taught by lectures. The old- 



fashioned study-and-recitation method is the 
only one which will bring success. 

The subject is commonly begun too late in 
the course and too little time is spent upon 
it. If young nurses are to handle drugs at 
all — and they must handle them if they give 
enemata, douches, help with dressings, etc. — 
they must know considerable about them or 
some one's life is in danger. There are few 
hospitals in which nurses with six months 
training do not give medicines regularly. 
Many an "accident" which has happened to 
a patient was due to a nurse's ignorance of 
the nature and effects of drugs. As a 
nurse cannot dust a room properly without 
a knowledge of the principles of bacteriology, 
so neither can she give a "one-two-three" 
enema intelligently without a knowledge of 
drugs. Begin the study, therefore, in the 
first year, and keep it up throughout the 
second. 

Go slowly at first. Insist upon a proper 
foundation. Have the courage to leave ap- 
parently important parts until the second 
year. Do not assume any knowledge on the 
part of your nurses. (Question a class of 
seniors and you may find half of them hesi- 
tating when asked the number of drams in 
an ounce.) Begin with the weights and 
measures, apothecaries' and metric, and be 
sure that they are well in mind. Next give 
four or five lessons on definitions of tech- 
nical terms. Drill them in. You will find 
it time well spent. Omit this, and your 
senior nurses go out from the hospital with 
ha/y ideas of simple things, to their own and 
your confusion. 

Then. I beseecli you, teach a few of the 
principles of chemistry. All books and all 
doctors nearly take this knowledge for granted. 



IN THE TRAINING SCHOOL 



37 



when only about one nurse in eight or ten 
really possesses it. You may know but little 
of chemistry yourself. Teach that little. 
Unless a nurse has learned what a chemical 
compound is and how chemical changes take 
place, she will never even grasp the meaning 
of the terms employed, much less the nature 
of the substances which they describe. The 
hospital druggist or a practical chemist can, 
with the aid of a few simple experiments, 
elucidate this matter in three or four les- 
sons. The nurses will, at the same time, get 
some help with their physiology, dietetics, 
and other studies. 

(Here we have had nearly ten lessons and 
have hardly begun our subject! None the less, 
it pays, as future classes will show.) 

For the first classes in the actual study of 
drugs, stick to the pedagogical principle of 
working from the known to the unknown. 
It is rank folly to begin with even such 
common drugs as the mercurials, opium, 
strychnia, aconite, belladonna, etc. Select, or, 
better still, let the class select, drugs of 
which they already know something — ^more 
than the name. Before they ever came to 
the hospital they were more or less familiar 
with castor oil, turpentine, flaxseed, camphor, 
mustard, glycerine, and some of the soda 
compounds. They do not know all about 
them, however, so teach these simple things 
first By the time they are finished the 
class will be ready for carbolic, boric, rhu- 
barb, cascara, etc., and the more difficult ones 
named at the beginning of the paragraph. 
Forty or fifty drugs are a goodly amount of 
work for the first year. Let thoroughness, 
not speed, be your watchword. Far better 
that your nurses know fifty drugs than that 
they have an indefinite notion of a hundred. 

If the first year's work is done by the 
superintendent of nurses, the second year 
can very well be handled by a doctor, and 
the class pushed rapidly through almost 
everything which is "in the book," certainly 
through everything which they need to know. 

Do not omit, and do not let your doctors 
omit, object teaching. It is far more effec- 
tive than any book recitation can possibly 
be. Obtain from one of the large firms of 
manufacturing druggists samples of the 
crude drugs. (Parke, Davis & Co. supplied 
me with beautiful and liberal specimens of 
roots, bark, leaves, etc., at an amazingly low 



price.) You will be astonished at the sud- 
den interest your nurses take when you show 
them something tangible. If they have once 
seen and handled hyoscyamus leaves, crude 
opium, or nux vomica buttons, they will 
never forget them. 

Besides the crude forms, take pains to 
get a sample of every common preparation 
of each drug studied. Get your druggist to 
put you up a two-dram vial of the kinds 
which are not in the hospital supply. Insist 
upon each nurse observing the appearance, 
odor, and in most instances the taste, of 
each prepartion. Crystalline substances 
should be shown in their crystalline form; 
it seems but fair that your nurses should 
know what carbolic and boric acids are like, 
and not imagine — as many of them do — 
that the one is a colorless liquid and the 
other a white powder. (Apropos of pow- 
ders, show them the different shades of 
white, and let them see that quinine, soda 
salicylate, bismuth subnitrate and cerium 
oxalate are not the same color.) Call their 
attention to the weight of substances, both 
solid and liquid. Show them that one sub- 
stance packs and another flies about. Let 
them see that liquids do not pour alike. 
Tell them these things, and they forget them 
before they leave the room; show them, and 
they remember them for years. 

About twice a year have a lesson in 
identification. Give the class small, un- 
labelled specimens of the prepartions which 
they have studied, and see how many they 
can name. Lessons of this sort do good 
work in fixing the characteristics of each 
drug in mind, thereby preventing mistakes 
in the giving of medicines. 

"But," some one objects, "all this takes 
time and money, more than we have." Par- 
don me, but it doesn't. Spend one-half hour 
in writing a list of drugs which you wish 
in the crude state, and fifteen minutes in 
getting off the letter which shall bring them. 
When they arrive, let the nurses unpack 
them, and they will have them half-learned in 
the process. Spend another half-hour on a 
list for your own druggist. Five dollars will 
more than cover the cost of the above. Five 
minutes time before each class will be 
enough to get out the material for the les- 
son and to note its characteristics. 



38 



THE TRAINED NURSE AND HOSPITAL REVIEW 



In class, you must take time, to be sure. 
But far better spend time in showing your 
nurses something which will stick in their 
memories, than in trying to drill dull facts 
into brains which find them hard to compre- 
hend just because they are dull and uninter- 
esting. 

Keep a text-book of Materia Medica fas- 
tened to each medicine case and encourage 
the nurses to use it. Its very presence will 
be a suggestion, and the habit of looking up 



the drugs which are being given will be 
readily acquired. 

May I not plead for a trial of new 
methods? The subject is badly taught in 
most hospitals and it is the method of teach- 
ing, mot <thc subject itself, which is re- 
spotisible. The ignorance in this branch dis- 
played by our nurses is both pitiful and 
dangerous. A little more care and attention 
given to this much-hated and much-neglected 
subject will bring results out of all pro- 
portion to the time and labor involved. 



Ohio. 

The graduating exercises of the Canfield- 
White Hospital Training School for Nurses, 
Cleveland, took place at the Euclid Avenue 
Presbyterian Church, East One Hundred and 
Seventh street. Rev. P. B. Stroup made the 
opening prayer. Miss Florence N. Maileue 
introduced the speaker, Dr. James C. Wood, 
who addressed the nurses on "The Co-opera- 
tion of the Trained Nurse in Surgical Work 
and the Great Benefits That Accrue There- 
from." 

Solos were given on the harp by Miss Caf- 
farelli, and piano by Miss Senta Rosenthal, 
and Mr. £. Jackson, who is possessed of a 
fine baritone voice, sang two selections. 

Dr. Mary H. White conferred the diplomas 
in a few well chosen words. Dr. Martha A. 
Canfield presented each nurse with a hospital 
medal and memory motto. 

Little Miss Mary Wirsching distributed 
flowers and favors very prettily. The gradu- 
ates were Hercey M. Alden, Louise B. 
Hensinger and Olive B. Woodman. 
After the commencement a banquet was held 
at the hospital, many friends of the institution 
being present. 

+ 

Illinois. 

The graduating exercises of the Chicago 
Baptist Hospital Training School for Nurses 
were held June 7th, at 8:30 P. M., in the 
Memorial Church of Christ. Diplomas were 
presented to Frances M. Steinhoff, A. Louise 



Mower, Mary Warren Althoff, Buelah F. 
Gribble, Cholro O. Gribble, Edith K. Long- 
hurst, Mollie B. Smith, Clara M. Johnson, 
Alice J. Potter, Pearl E. Monroe, Alma Nel- 
son Spalsbury,. G. Eleanora Felland, Cholra O. 
Harrison. 



The Wesley Hospital Training School for 
Nurses (affiliated with Northwestern Uni- 
versity), of Evanston, held graduating ex- 
ercises on the morning of June 8th, at the 
Northwestern University Gymnasium. Diplo- 
mas were awarded to Ethel E. Ennis, Eliza- 
beth Wolfe, Matilda Louise Zilch, Ada Bell 
McCleery, Nellie Louise Wilder, Mabel Clara 
Barton, Elizabeth V. Condell, Gretchen Deach, 
Manetta Rebecca Bell, Frances Regina Wil- 
son, Ethel Rozella Rest, Olivia Anna Theresa 
Peterson, Virginia Blanche Killingsworth, L 
Anna Carpenter Hall, Edna Allison Furgu- 
son, Laura Elizabeth Crawford, Blanche Alice 
Meyers, Vera Howard Murry, Helena Van 
Winkle, Edna May Brand, Ella Augusta Baker 
and Inna Estel Neff. 



Personal. 

Miss Alma C. Carlstrom, of Chicago, 
sailed for Europe the 26th of May. She in- 
tends to spend a most delightful vacation with 
relatives and friends. Miss Carlstrom, who is 
a graduate of the Washington Park Hospital 
Training School, Chicago, class of *09, will re- 
turn to Chicago in the Fall, where she will 
take up private nursing. 



Jin tje Jturfitng: Wnxlt> 

ARTICLES IN THIS DEPARTMENT, WHETHER BEARING SIGNATURE OR NOT, ARE CONTRIBUTED, AND 
DO NOT NECESSARILY REPRESENT THE IDEAS OR POLICY OF THIS MAGAZINE. 



The National Societies. 

The Sixteenth Annual Convention of the 
American Society of Superintendents of 
Training Schools for Nurses was held in New 
York City May i6th, 17th, at the Academy of 
Medicine, 17 West Forty-third street. 

The meeting was called to order May i6th, 
at 10:15 A. M., by the president, M. Adelaide 
Nutting. Rev. Henry Lubeck, LL.D, D.C.L., 
rector of Zion and St. Timothy's Church, in- 
voked the divine blessing on the assembly. 

Address of welcome by President Finley, 
of the College of the City of New York. 
President Finley traced the progress and de- 
velopment of the nurse from her first ap- 
pearance in mythology to the present day. His 
remarks were laudatory and appreciative of 
the value of the profession in the broader 
interpretation of its purport. 

"The nurse to-day is a warrior with foes 
invisible and insidious, a modern Joan of 
Arc." In the epoch now beginning the psy 
chical aspect of nursing is prominent. "Psy- 
chical bacilli" as well as physical must be 
overcome. The nurse must come "close to the 
souls as well as the bodies of men,'* and for 
this President Finley recommends the highest 
possible intellectual training, the inculcation 
of a spirit of readiness and self-abnegation; 
such discipline as fits men for war. 

Response by Georgia M. Nevins. Miss 
Nevins thanked President Finley for his cor- 
dial welcome and his understanding and ap- 
preciation of the profession, saying that the 
provinces get the inspiration of the year from 
this visit to New York. She closed with a 
reference to the great loss to all nurses in the 
death of Isabel Hampton Robb, paying in a 
few well chosen words such tribute to Mrs. 
Robb as only such a great loss could inspire. 

Address of President M. Adelaide Nutting. 
Miss Nutting spoke first of Mrs. Robb, of the 
great personal loss placed even before her 



great work. She was first a great woman, 
and then a great nurse. 

She then spoke of the death of Miss Isla 
Stewart and the association's sympathy with 
England. 

The Superintendents' Society now has 350 
members. In Miss Nutting's opinion the 
training schools are the pivots on which nurs- 
ing must turn and advance. Their heads must 
be women of power and ability. Undereduca- 
tion is the cause of our deficiencies. High 
standards must be upheld. There is ground 
for encouragement. We grow and change and 
must be ever ready for the new. 

Isabel Mclsaacs spoke of Mrs. Robb from 
the standpoint of her pupil associate and per- 
sonal friend. A committee consisting of Miss 
Mclsaacs, Miss Dock and Miss Nevins was 
appointed to prepare resolutions to express 
the convention's sorrow and loss in Mrs. 
Robb's tragic death. 

Mrs. Helen Hartley Jenkins, who recently 
gave so generously to the work of the Hos- 
pital Economics course at Columbia, was in- 
troduced. 

Report of the council by the secretary, M. 
Helena McMillan, read and acepted. Resigna- 
tion of Miss Linda Richards read. Voted not 
to accept this resignation and to extend to her 
honorary membership for life. The secretary 
was instructed to telegraph her of this action. 

Voted to send a cablegram of greeting to 
Florence Nightingale. The chair appointed 
for this a committee consisting of Misses 
Goodrich, Maxwell, Hay and Delano. 

Voted to send a telegram of greeting to 
Miss Drown. Appointed for this Misses 
Riddle, Delano and Stowe. 

Treasurer's Report, Anna L. Alline, read 
and accepted. 

Standing Committees. 

Hospital Economics Course, Annie W. 
Goodrich. The course at Columbia is now 
known as "The Department of Nursing and 



40 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Health," and its divisions are: Teaching, 
General Supervision Public Service, and Pre- 
paration for Training School Course. Re- 
port accepted. 

The Committee recommends that a chair to 
be known as the Isabel Hampton Robb chair 
be established as a memorial to Mrs. Robb. 
A preliminary committee, chairman, Isabel 
Mclsaacs^ was appointed to consider this 
recommendation and to appoint a committee 
as a Robb Memorial Committee. 

Committee on Red Cross work discon- 
tinued. Voted to create a new committee to 
be appointed by the council as an Advisory 
Committee to the National Red Cross Nurs- 
ing Organization. 

Announced that the committee appointed 
to confer with the Civic Federation of Wo- 
men's Clubs was discontinued. 

Discussion on the necessity for State and 
local societies of training school superintend- 
ents. 

Miss Nutting, "Miss Alline, Miss Noycs and 
others. 

.The trend of the discussion was that local 
societies are needed; are helpful where they 
have been established; are hard to establish. 

Voted; 'ihat a Committee on Revision of 

the By-laws be appointed by the council. 

Adjourned. 

Afternoon Session. 

Call to order 2:25 P. M. 

Report of Committee on Education, Helen 
Scott Hay, chairman. 

Miss Hay said that her committee had been 
made up of women who were specialists in vari- 
ous branches of training and that each would 
present her specialty. Miss Ayres, of the 
.Manhattan Eye and Ear Hospital, of New 
York City; Miss Russell, of Sloane Maternity 
Hospital, New York, and Sister Amy, of the 
Children's Hospital, Boston, gave accounts 
of the need for special training, the time re- 
quired and the methods employed and de- 
sired in each of these branches. 

Affiliation of the general with the special 
hospital the best method where practicable. 
A graduate of a special hospital in charge of 
a special ward in the general hospital as sec- 
ond choice. 

Three to six months undivided time for 
each specialty with definite cour^^e of study 
and instruction therefor. 

The discussion brought up the subject of 



electives, but while many thought it well to 
choose specially fitted nurses for this special 
training, the making of an elective course 
was not favorably received on the ground that 
it might interfere with the hospitals' need. 

Paper: "The Problem of the Child in the 
Hospital," Amy McMahon, of the Johns Hop- 
kins Hospital, Baltimore, Md. 

Ross Robertson, of Toronto, introduced by 
Miss Nutting, ^poke appreciatively of nurses 
and told of the very considerable work he 
has been able to do, and hopes to do, to im- 
prove living conditions in nurses* homes. 

Henry G. Parsons was introduced and told 
of the work done in establishing childrens' 
gardens in New York City. 

Adjournment. 

Tuesday, May 17th. 

Report of Council. 
Report of Auditors. 

Report of Progress in Army and Red 
Cross Nursing, Jane A. Delano. 

Report on Develoments in Navy Nursing, 
Esther V. Hasson. 

Continuation of Report of Committee on 
Education. 

Nursing of Nervous and Insane. 
Sara T. Parsons, Massachusetts General 
Hospital. Miss Parsons recommends six or 
nine months for this specialty. Discussion to 
the effect that it should not be part of gen- 
eral curriculum, but preferably post-graduate 
work. Knowledge of psychology essential. 

Report of Special Committee on Post- 
Graduate Work, Annie Goodrich, chairman. 

Miss Goodrich advocated post-graduate 
work for specialization. It should not be de- 
veloped as a means of supplying the de- 
ficiencies of training school courses. 

"Miss Dock obtained the floor and recom- 
mended the assembly to take some definite 
action to secure fair treatment of training 
school superintendents by hospital authorities, 
citing two instances wherein such action 
would be pertinent. Miss Nutting explained 
that in the one case the council, which rep- 
resented the society, was making careful in- 
quiry. In the other case she expressed regret 
that a matter of a personal nature should 
have been thus put before the meeting. The 
superintendent whose course of action had 
been related by Miss Dock obtained the floor 
and spoke tersely in defense of her position. 



IN THE NURSING WORLD 



41 



Tuesday, 2:15 P, Af. 

Paper: "Student Government in Colleges." 
Julia Stimson, Harlem Hospital. 

Paper: "How Far the Principles of 
Student Government May Be Applied to 
Training Schools." Luella Goold, Memorial 
Hospital, Taconia, Wash. 

Discussion. Misses McEchnie, Greenwood, 
Hay, Carr, Maxwell and Sister Amy. 

Paper: "The Preparation of the Teacher 
for the Training School." Lydia Anderson, 
Mount Sinai Training School. 

Paper: "Ward Supervision." Georgina J. 
J. Sanders, Polyclinic Hospital, Philadelphia. 

Voted, that the Council appoint a commit- 
tee to consider the application of student gov- 
ernment to the training school. 

Voted, that the Council appoint a commit- 
tee to study the relative merits of graduate 
and student head nurses. 

Address: "Relation and Proportion of 
Theory to Practice in Vocational Training." 
Dr. F. M. McMurray, Professor of Ele- 
mentary Education, Teachers' College, Co- 
lumbia Universtiy. 

The "Relation and Proportion of Theory," 
as expounded by Dr. McMurray, while keenly 
interesting from the purely pedagogic stand- 
point, was unpractical and impracticable from 
the nursing training school point of view, as 
was evidenced by his suggestion of the divis- 
ion of time spent in theory and practice, 
"half and half." 

New officers introduced. 

The next meeting to be held in Boston. 

Adjournment. 



A joint meeting of the American Society of 
Superintendents of Training Schools for 
Nurses and the Nurses' Associated Alumnae 
of the United States was held at Teachers' 
College, Columbia University, in the Horace 
Mann Auditorium, on Wednesday, May i8th, 
at 2 P. M. The subject of this session was 
the occupation of invalids, and a large and 
interesting collection of work done and 
methods of working was on exhibition in 
one of the college rooms. 

The formal programme was : 

Address of welcome, James E. Russell, 
LL.D., Dean of Teachers' College. 

Dean Russell spoke of Mrs. Robb, of his 
personal knowledge of her ability and her 



never flagging zeal in putting her profession 
on a higher educational basis. 

Paper: "The Training of the Nurse as 
Instructor in Invalid Occupations." Miss 
Susan £. Tracy, Jamaica Plains, Mass. 

Paper: "Successes and Failures in the Use 
of Occupation as a Therapeutic Agent." Dr. 
Mary Lauson Ncff, Long Island State Hos- 
pital. 

Paper: "Manual Work as a Remedy." Dr. 
J. Herbert Hall, Marblehead, Mass. 

Dean Russell, at this point recognized Dr. 
Livingstone Ferraut in the audience and 
asked him to speak. Dr. Ferraut spoke most 
instructively about his experience with oc- 
cupation and non-occupation in tuberculosis 
cases. 

"Not on the programme, but the best thing 
we have had," was overheard in the audi- 
ence. 

Paper: "What Art May Contribute to 
Instruction in This Field." Professor 
Arthur Wesley Dow, Teachers' College, 
Columbia University. 



The Nurses' Associated Alumnae of the 
United States held its thirteenth Annual Con- 
vention at Mendelssohn Hall, 113 West 
Fortieth street, New York City, on May 18 
to 21, 1910. 

The morning session of Wednesday, May 
18, was devoted entirely to registration of 
delegates, members and visitors; the payment 
of dues; issuing of tickets for the Nightin- 
gale commemorative celebration and for the 
harbor trip for Saturday. The afternoon 
session, a report of which is given above, 
was held jointly with the Superintendent's 
Society, at Teachers' College. 



The session of Thursday morning opened 
at 10:10. Jane A. Delano, president, in the 
chair. 

The divine blessing was invoked by Rev. 
Henry Sloane Coffin, D.D. 

Address of welcome. Dr. S. S. Goldwater. 

Response to address of welcome by Isabel 
Mclsaacs. 

Roll call of affiliated societies. 

Announcement made by Miss Delano of the 
absence from the convention of three women, 
usually so prominent: Miss Palmer, now con- 
valescing, after a serious operation; Miss 



42 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Darner, suffering with serious eye trouble, 
the result of an accident, and Mrs. Robb, 
whose tragic death occurred so recently. 

Tributes to Mrs. Robb followed. Among 
those who spoke were Miss Hay, Miss Mc- 
Isaacs, Miss MacMillan and Miss Nutting, 
who spoke on Mrs. Robb's influence and share 
in the work at Columbia, and in general her 
work along educational lines. 

Announcement made of the death of Miss 
Upjohn, who died at sea, May lo. A tribute 
to her by Miss Edna R. Foley, read by the 
secretary. 

Report of the secretary, Agnes G. Deans, 
read and accepted. 

Report of Treasurer Anna S. Davids, read 
and accepted. 

Reports of standing committees, eligibility, 
nominating and programme, accepted. 

Address of President Jane A. Delano. 

Miss Delano laid emphasis on two epochs 
of nursing. The first, the epoch of Florence 
Nightingale and the establishment of the 
training school; the development from the 
need as evidenced in relief work at Solferino. 
The second, the epoch on the threshold of 
which seventy-five thousand nurses now stand : 
the epoch of preventive work. 

That nurses and nursing are challenged 
constantly is a hopeful sign, an incentive to 
progress and improvement. 

The great work of this epoch is to be 
along social lines; *'the nurse is privileged to 
pass the gulf between high and degraded 
without contamination" and thus to help this 
class is particularly her field. 

The word for the future is "cultivate the 
general good for all." 

Demonstration of a Registry System. Dr. 
Marion A. Meade, Minnesota. 

Dr. Meade explained, from a model, an ex- 
tremely simple, practical and effective regis- 
try system. Her remarks were full of humor 
and her personality so pleasing that, no doubt, 
to it is partially due the success of her regis- 
try. Questioned as to what was her office 
force, she replied, "Myself and a collie dog," 

Announced: Committee on resolutions — 
Miss Hartridge, Miss Giles, and Miss Fagan. 
Inspectors of election — Miss Golding, Miss 
Kelly, and Miss Mack. 

Voted : That the chair appoint a preliminary 
committee, this committee to appoint a com- 
mittee to confer with the committer f^ppointcd 



in like manner by the Superintendent's Society 
to decide on a fitting memorial for Mrs. Robb. 
The chair reserved the appointment. 

Announced: That invitations had been re- 
ceived to hold the next annual meeting in 
Boston, in St. Louis, and in Chicago. 

Miss Delano spoke of the very considerable 
work and inadequate pay therefor of the 
secretary, and made the recommendation that 
the society consider the appointment of a field 
secretary whose duties should be the further- 
ing of Associated Alumnae interests, Red 
Cross work and the American Journal of 
Nursing, and that she be maintained by these 
three organizations, jointly. 

Vbted: That messages of greeting and 
good wishes of the association be sent by the 
secretary to Miss Drown, Miss Richards, Miss 
Darner and Miss Palmer. 

Afternoon Session, 2:15 P. Af. 

Symposium on Private Duty Nursing. 
Katherine De Witt, presiding. 

Paper, "Some Aspects of Private Duty 
Nursing." Ruth Brewster Sherman, Balti- 
more. 

Miss Sherman's paper was read by Miss 
De Witt. 

Paper, "Special Duty Nurse in Institutions. 
Caroline C. Foote, Chicago. 

Miss Foote*s paper was read by Miss Jones. 

Paper, "Private Duty in Rural Homes.'* 
Margaret Peppoon, San Diego, Cal. 

Discussions on these papers by Miss Dur- 
kee, Mrs. Morrisson and others. 

MISSIONARY NURSING. 

Address, "Opportunity for Nurses in 
China." Sarah C. Tomlinson, a missionary 
nurse. 

Address, "The Awakening World." Rev. 
Samuel Zwemer, D.D. 

By special request Mr. Henry Parsons re- 
peated for the Alumnae his descriptions of 
Children's Gardens, given before the Superin- 
tendents' Society. His address was heard 
with much interest, and many accepted his 
invitations to visit the "gardens" about the 
city. 

Announced: The preliminary committee on 
the Robb memorial to consist of Anna L. 
Alline, Genevieve Cooke and Clara D. Noyes. 
Friday Morning Session, Opened 9:40 A. M, 

Report of Interstate Secretary, Miss Agnes 
G. Deans, read and accepted. 

Miss Mclsaacs announced that the Ameri- 



»f 



IN THE NURSING WORLD 



43 



can Journal of Nursing would be responsible 
for the payment of $300 annually, as its share 
of the expense of a field secretary, should 
such office be created, according to Miss 
Delano's plan. 

Reports of special committees. 

District Nursing. Mary E. Lent, Baltimore, 
read by Mrs. Sly. 

Public Health. Mrs. Colvin, read by Miss 
Dock. 

Tubercular Nursing. Edna R. Foley, Chi- 
cago, read by Mrs. Tice. 

Insane Nursing. 5'ara Parsons, Boston. 

Pension Fund, M. E. P. Davis, Washing- 
ton. 

This committee had been continued for 
three years; had made thorough and ex- 
haustive investigations of pension and insur- 
ance systems, but had found them inapplicable 
to this organization. The committee had 
nothing to recommend for a pension or relief 
fund instituted and carried on by a nurses' 
organization for its members. 

Considerable discussion was evoked by this 
report, and the suggestion that more desir- 
able than a pension system was the inculca- 
tion of habits of thrift in the individual met 
with a response, the meaning of which was 
easily reducible to the principles of socialism. 

The committee was dismissed with a vote 
of thanks to Miss Davis for her painstaking 
investigation. 

Almshouse Nursing. L. L. Dock, with sup- 
plementary reports by Mrs. Tice. 

No formal action was taken on these re- 
ports. 

Report of International Council of 1909. 
Lavinia L. Dock. 

The Council of 1912 will be on social and 
preventive aspects of nursing. 

Report on the progress of Red Cross Work. 
Jane A. Delano. 

Announced: That the Robb Memorial Com- 
mittee to confer with the committee appointed 
by the Superintendents' Society is composed of 
Miss Delano, Miss Riddle, Miss Dock, Miss 
Mclsaacs and Mis^ Palmer. 

Report of Committee on Reorganization. 
Genevieve Cooke, California. 

Name: General discussion; no definite ac- 
tion. Federation of Nurses' Societies of the 
United States favorably commented upon. 

Meetings: Voted to instruct the reorgani 



zation committee to recommend meeting once 
in two years. 

Organisation: Voted that the committee 
recommend an organization of individuals 
paying dues. 

Dues: That the committee recommend that 
individual or permanent members pay dues 
of $1.00 yearly. An attempt to amend this 
motion to make dues include stA>scription to 
the American Journal of Nursing was lost. 

A motion to reconsider the original ques- 
tion was lost. 

Officers: Voted that this committee rec- 
ommend a council composed of presidents 
of affiliated State societies to act with the 
board of directors. 

Nominations: Voted that the committee 
recommend that any name shall have ten 
indorsements before being considered by the 
nominating committee. 

Voted that this committee recommend that 
State associations remain affiliated as at pres- 
ent, with one vote. 

The question of the unit of membership 
was referred back to the committee for fur- 
ther consideration. 

Friday, P. M. 

Called to order 2 p. m. 

Paper: "Nursing Care of the Insane," Dr. 
William Malbon, New York. 

Paper : "Ethics," Helen Scott Hay, Chicago. 

Miss Dock reported that the joint delibera- 
tions of the Robb memorial committees of 
the two societies resulted in the following: 

The committee recommends that a fund 
of $50,000 be established, to be known as the 
Isabel Hampton Robb Fund, this fund to 
be maintained for scholarships for special 
training in educational institutions of nurs- 
inir. 

Voted that the recommendation of this 
committee be adopted and arrangements made 
for carrying out the plan. 

Pledges approximating $2,000 in amount 
were at once made with great enthusiasm. 

Voted that the executive committee be em- 
powered to increase the salary of the secre- 
tary, according to the recommendation of the 
president, Miss Delano. 

Voted to elect from this association a field 
secretary, to be maintained by the Red Cross 
Society, the American Journal and the Asso- 
ciated Alumnae conjointly, and whose work 



44 



THE TRAINED NURSE AND HOSPITAL REVIEW 



shall be the furtherance of the interests of 
each organization. On the nomination of 
Anna S. Davids, Isabel Mclsaacs was unani- 
mously elected to this new office. 

Election returns, announced by Miss Gold- 
ing: 

270 votes cast, 3 of which were illegal. 

For president, Jane A. Delano, 267 votes. 
First vice-president, Helen Scott Hay, 170 
votes; Mrs. A. R. Colvin, 97 votes. Second 
vice-president, M. E. Fisher, 166 votes; Eva 
A. Mack, loi votes. Secretary, Agnes G. 
Deans, 267 votes. Treasurer, Mrs. C. V. 
Twiss, 142 votes; Anna G. Davids, 125 votes. 
Directors for -three years, Isabel Mclsaacs 
and Anna Maxwell. 

After the introduction of new officers. 
Miss Delano spoke most pleasingly as she 
said "the outgoing and incoming president." 
She spoke for the unanimity of spirit and 
purpose necessary for the furtherance of the 
association's welfare, and for the welfare of 
the profession. Her message for the dele- 
gates going back to their home societies was 
"work together." 

A rising vote of thanks was given Miss 
Davids for her long and efficient service as 
treasurer. 

Appointment of nominating committee by 
the chair: Miss Loomis, Miss Gillette. From 
the floor: Miss Davids, Miss Milne and Mrs. 
Nichols. 

Report of committee on resolutions read 
and accepted. 

Discussion on the place of next meeting. 
A motion to hold the next meeting in "the 
Middle West" was lost. 

Mrs. Tice withdrew the invitation issued 
by Chicago in favor of the invitation issued 
by Boston. 

Voted that the invitation to hold the Con- 
vention of 191 1 in Boston be accepted. 

Voted that thanks be sent to St. Louis for 
its cordial invitation to meet there. 
Adjournment. m 

NtyM York. 

The graduating exercises of the Metro- 
politan Training School, Blackwell's Island, 
New York City, were held on May 21st. 

Among the speakers was Miss Jane A. 
Delano, Superintendent of the Army Nurse 
Corps, Surgeon General's Office, Washington, 
D. C, who urged the nurses to take advantage 



of every opportunity to prepare themselves as 
teachers, as this seemed to be the field of 
greatest opportunity and usefulness. In priv- 
ate duty there was much opportunity where 
advice was wisely given, especially in con- 
tagious diseases; there was a wide field in 
school or district work and the increasing 
number of positions always open in institu- 
tions. 

Four prizes awarded the graduating class 
were won as follows: 

The Egbert Guernsey Prize, $50, Jessie 
Paton Allan. 

The Cosmo D. O'Neil Prize, $50, Elvira 
Sutland Treacy. 

The prizes for best bedside record and tem- 
perature chart, a hypodermic, Jessie Paton 
Allan; a thermometer, Caroline Louise 
Goetchius. 

Two prizes awarded the intermediate class 
were won by Caroline Wilde, $25 ; Maud Ezma 
Charlton, medicine spoon. 

Each member of the class was presented 
with a beautiful bouquet of roses by Hon. 
Michael J. Drummond, Commissioner. A 
modified version of the hippocratic oath was 
administered by Mrs. William Kinnicutt 
Draper, President of the Advisory Board, af- 
ter which the diplomas were presented. 

The following is the form of oath as ad- 
ministered : 

"You do solemnly swear, each one by 
whatever she holds most sacred : 

"That you will be loyal to the physicians 
under whom you serve, as a good soldier is 
loyal to his officers. 

"That you will be just and generous to all 

worthy members of your profession, aiding 

them when it shall be in your power so to do. 

"That you will lead your lives and practice 

your profession in uprightness and honor. 

"That into whatsoever house you shall 
enter, it shall be for the good of the sick to 
the utmost of your power, and that you will 
hold yourselves aloof from all temptation. 

"That whatsoever you shall see or hear of 
the lives of men and women, whether they be 
your patients or members of the households, 
you will keep inviolably secret, whether you 
are in their households or among your own 
friends. 

"If you accept these obligations let each 
one bow the head in sign of acquiescence. 



46 



THE TRAINED NURSE AND HOSPITAL REVIEW 



*'If you shall be fVue to your word may 
prosperity and good repute be ever yours ; the 
opposite if you shall prove yourselves for- 



sworn. 



If 



Florence Nightingale Celebration. 

Exercises in commemoration of the 
fiftieth anniversary of the founding by Flor- 
ence Nightingale of the first training school 
for nurses were held at Carnegie Hall Wed- 
nesday evening, May i8th, at 8:30 o'clock, in 
which the following prominent speakers took 
part: Invocation, Rt. Rev. David H. Greer, 
D.D.; Opening Address, Professor Henry 
Fairfield Osborn, of Columbia University; 
"The Soldier Nurse," Colonel John Van R. 
HoflF, Medical Corps, United States Army; 
"What Florence Nightingale Did for Man- 
kind," the Hon. Joseph H. Choate; "The In- 
fluence of the Trained Nurse Upon Develop- 
ments in Medicine," Dr. William Polk, Dean 
of Medical School, Cornell University; Bene- 
diction, the Rt. Rev. Monsignor LavcUe, rep- 
resenting the Archbishop of New York. The 
choirs of St. George's Church and of the 
Cathedral of St. John the Divine furnished 
the vocal music, and Mr. Homer Norris was 
at the organ. The hall was beautifully dec- 
orated and the arrangements were carried 
out with great perfection. There was a very 
large audience. 



Red Cross Nursing Organization. 

The New York committee on Red Cross 
Nursing Service has decided to begin the 
work of establishing local committees by di- 
viding the different counties among five or 
six districts, with headquarters at Rochester, 
Syracuse, Albany, Manhattan and Brooklyn. 
After these committees are thoroughly estab- 
lished and the number of enrollments warrant 
it, the number of local committees will be 
increased. The most noticeable feature of 
the plan of organization for Red Cross Nurs- 
ing organization which has been prepared by 
the National Committee is the recognition 
given to the nursing organizations. In every 
case when a committee is to be appointed, 
whether National, State or local, the candi- 
dates for membership on it are nominated by 
the nursing organization. Also if a nurse 
wishes to enroll and is a member of any 
nurses' society, she must be endorsed by her 



society in order to be eligible for enrollment. 
It will take considerable time to get all the 
committees to work, but it is believed that 
the system will make the enrollment for Red 
Cross Nursing Service truly National in every 
sense of the word. 

These local committees will meet monthly 
and their principal work will be to look after 
the enrollment and to decide upon the head- 
quarters for enrolled Red Cross nurses in 
their district. It is also the duty of the local 
committee "to send the circular of informa- 
tion to the superintendent of training schools, 
secretaries of alumnae associations and other 
nursing organizations in their locality, to ar- 
range for Red Cross meetings for nurses and 
to advance in every way possible the nursing 
service of the Red Cross." 

+ 
Massachusetts. 

The Spring meeting of the New England 
Association for the Education of Nurses was 
held in Huntington Hall, Boston, on May 20 
and proved to be unusually interesting. The 
subject of the evening was: "The Education 
of Nurses for People in Moderate Circum- 
stances." 

Dr. Palmer in his opening address spoke of 
the general movement for the conservation 
of the national health and of how much is 
being done to reduce the death rate from pre- 
ventable diseases. He spoke of the rich hav- 
ing the trained nurse and the poor the dis- 
trict nurse to care for them, but said a large 
middle class was left unprovided for. He 
then, after mentioning some of the solutions 
proposed for the problem, introduced Miss 
Frances H. Bescherer, head nurse of the 
Guild for the Care of the Sick, in Albany, 
N. Y. 

Miss Bescherer, in a paper entitled "A 
Partial Solution of the Problem for Supply- 
ing Nurses for People of Moderate Income," 
told of the work of the Albany Guild, 
of its two and one-half years* course 
for trained attendants or "domestic nurses," 
with theoretical lectures and practical les- 
sons, and of the case work of pupils under 
careful supervision by a graduate and their 
daily reports. At graduation the nurse gets a 
certificate as a "certified Guild nurse," and she 
is allowed to make a maximum charge of $15 
a week. The school uses a sliding scale in its 



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48 



THE TRAINED NURSE AND HOSPITAL REVIEW 



charges to patients, charging according to 
their ability to pay, and it has been calculated 
a pupil brings in $87.00 beyond her board 
and lodging. 

Dr. Lefavour, of Simons College, who was 
to have opened the discussion, sent a letter of 
regret in which he said he did not consider 
that domestic nurses would interfere with 
trained nurses. 

Dr. Alfred Worcester thought two solu- 
tions of the problem were possible. First, 
partially trained nurses, and second, student 
nurses. He referred to the White Cross So- 
ciety of Holland, where first, second, third and 
fourth class certificates are given, a nurse be- 
ing allowed to work up from a lower to a 
higher grade, if capable of doing so. Of 
the two solutions he recommended the student 
nurses, provided they were supervised by a 
graduate nurse. He also thought district 
nursing associations could co-operate. 

Mrs. E. A. Codman, of the Boston Instruc- 
tive District Nursing Association, suggested 
a central home, run on a business basis, 
which should be the headquarters of the Dis- 
trict Nursing Association, affiliation to be 
made, if possible, with such other organiza- 
tons as the Massachusetts General and Bos- 
ton City hospitals, whose students could be 
sent out under supervision. 

Miss Grogan, who had recently been travel- 
ling through New England, said she had 
spoken with the superintendents of various 
hospitals and they generally approved of 
student nurses as the solution of the problem. 

Dr. Hugh Cabot did not approve of educat- 
ing attendants, as it inflicted poorly trained 
and ill-bred nurses on the public. He thought 
the problem could not be solved by student 
nurses till the larger hospitals realized their 
responsibility to the community as well as 
themselves and were convinced they could 
carry out the scheme without increased ex- 
pense. 

The following officers were elected : 

President, Dr. Lewis M. Palmer; vice- 
presidents, Dr. Richard C. Cabot (Mass.) . 
Miss Ellen F. Paine (Me.) , Dr. Henry C. 
Hall (R. I.), Miss Eva J. Cook (Vt.), Miss 
Ida F. Shepard (N. H.), Miss R. I. Al- 
baugh (Conn.); secretary, Miss Annette 
Fiske; treasurer, Dr. Hugh Cabot; Executive 
Committee, Miss Lucy Ayres, Sister Amy 
Margaret, Miss Emma A. Anderson, Dr. G. 



S. I. Badger, Mrs. H. L. Burrell, Miss 
Adeliza Betts, Mrs. E. A. Codman, Miss 
Louise Coleman, Miss Beatrice De Veber, 
Miss A. N. Flash, Mrs. Harry Hough- 
ton, Miss Sarah Hayden, Dr. W. O. 
Mann, Miss Frances E. Morley, Miss Ella 
McCobb, Miss Emma M. Nichols, Dr. F. W. 
Patch, Mrs. William T. Piper, Miss Parsons, 
Miss Mary A. Riddle, Dr. F. H. Thompson, 
Miss Susan E. Tracy, Mrs. W. W. Vaughan, 
Dr. F. A. Washburn, Dr. Grace Wolcott, Dr. 
Alfred Worcester, Dr. George Tuttle. 



Nurses* Examination, 

Post-graduate School of The Boston 
Floating Hospital. 

Express your meaning clearly. Reread your 

answers. 

1. What is the object of the addition of 

cereal diluent, such as barley water, to 
milk mixtures? 

2. What temperature should be provided for 

a premature infant? 

3. What would you do, until the doctor ar- 

rived, for a child taken suddenly with 
convulsions ? 

4. What is meant by the term "cream"? How 

is cream obtained at home? 

5. What is meant by the term "Lavage" and 

"Gavage," used in the treatment of gastric 
diseases? Method of giving the same. 

6. Describe the signs of onset of acute febrile 

disease in childhood. 

7. Describe the anterior fontanelle. 

8. What are the reasons for giving castor 

oil in Infectious Diarrhoea? Its dose for 
the usual two-year-old child? 

9. What must be done to whey before it is 

mixed with cream or milk? 

10. What is the difference between the cry of 
pain and that of hunger? 

+ 
Connecticut. 

The Alumnae Association of St. Francis 
Hospital, Hartford, held its semi-annual 
meeting at the hospital May 12, 1910. 

Miss N. A. Ryan, R. N., president, in the 
chair. Ten new members were elected to 
membership in the association. 

Interesting papers were read: "Kindness," 
by Miss M. A. Ahem; "Surgical Experi- 
ences/' by Miss M. G. Murphy; "Semi- 
Trained Nurse," by Miss S. A. McNabb. 



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50 



. "^ S16 

THE TRAINED \i\^SE 

Miss R. I. Albaugh, R. N., gave a vtty^'^ 
teresting talk to the Association regarding" 
the necessity of nurses carrying an insurance 
as a protection for the future. 

The graduating class of 1910 were given a 
reception by the Alumnae Association. 

The following nurses have recently re- 
ceived their diplomas: "Mary Josephine Bar- 
rett, Mary Margaret Moore, Mary Teresa 
Sullivan, Elizabeth Irene Sparadoski, Mary 
Elizabeth McEnanny, Loretta B. Donahue, 
Sarah Cecilia Martin, Helen Amelia Bligh, 
Alice Francis Nash, Annie Zita Lynn. 

+ 
Pennsylvania. 

The Fifth Commencement of the Harris- 
burg Hospital Training School for Nurses 
was held Thursday evening, May 26, 1910, in 
the Memorial Hall of the Harrisburg Hos- 
pital, Harrisburg, Pa. 

Miss Clara M. Swank, the Superintendent, 
gave a very interesting and encouraging re- 
port of the Training School. 

The address to the graduating class was de- 
livered by Rev. John Mills Gilbert. The 
presentation of the diplomas was by Pro- 
fessor William S. Stule, of the Harrisburg 
High School, and the school badge was pre- 
sented by Dr. F. W. Coover, M.D., Dean of 
Staff of Surgeons and Physicians of Harris- 
burg Hospital. 

Updegroove's String Quintette furnished 
the music for the evening. 

Following the exercises Mrs. Henry Mc- 
Cormick gave a reception. 

The following are the graduates: 

Miss Martha Offman, Miss Fredericka 
Clausen, Miss Mary Dettling, Miss Anna 
Grace Robins, Miss Louise Pattison, Miss 
Clara Orelia Redmond, Miss Emma Eliza 
Swomley, Miss Susan Catherine Hoofnagle. 



o: 



JAL REVIEW 



AND HOS: 

* ^[ "WiOji^rtlibership of this year's graduating 
class were elected to membership of the 
Nurses' Alumnae. The members are as fol- 
lows : 

Miss Martha Elizabeth Offman, Miss 
Fredericka Clausen, Miss Mary Dettling, Miss 
Anna Grace Robins, Miss Louise Patterson, 
Miss Clara Orelia Redmond, Miss Emma 
Eliza Swomley, Miss Susan Catherine Hoof- 
nagle. 



The Second Annual Meeting of the Nurses' 
Alumnae Association of the Harrisburg Hos- 
pital was held Thursday, May 26, 1910, at the 
hospit il. 

The new officers for the coming year were 
elected as follows: 

President, 'Miss Almeda Morrison; first 
vice-president. Miss M. May Stoner; second 
vice-president, Miss Josie Lewis; secretary. 
Miss Frankford Lewis; treasurer. Miss Jessie 
McClure. 



The Alumnae Association of the Philadel- 
phia Lying-in Charity Hospital Nurses' School 
gave a reception for the graduates and friends 
of the class of 1910 in the lecture room of 
the hospital on Friday evening, June 3d, at 8 
P. M. The lecture room was beautifully' dec- 
orated with flowers and the school colors — 
navy blue and yellow. Those present had a 
very delightful evening in the reunion of 
friends and classmates, and many stayed to 
enjoy dancing and refreshments. 



The regular monthly meeting of the Alumnae 
Association of the Philadelphia Lying-in Char- 
ity Hospital was held on Friday evening, June 
3d, before the reception to the graduating 
class of 1910. 

Miss M. Wright, president, in the chair. 
Seventeen members present at the meeting. 
Minutes of last meeting read and approved. 
One new member received in the Association. 
Meeting adjourned to meet the Reception 
Committee and attend the reception in the 
lecture room. Next Alumnae meeting first 
Thursday afternoon in September at 3 o'clock. 



The Seventeenth Annual Commencement of 
the Training School for Nurses of the Jewish 
Hospital of Philadelphia were held Monday, 
May 30th, at 3 o'clock P. M. The address to 
the graduates was by Dr. E. E. Montgomery, 
and the diplomas were presented by Mr. Will- 
iam B. Hackenburg, president of the hospital. 
A very interesting feature of the programme 
was the presentation by Mr. Edward Stern, of 
the following prizes : 

To Miss Mary Jacobs, the Matilda Kauf- 
man Gold Medal, for having made the best 
general average covering a period of three 
years, the full term of instruction. 

The Joseph L. Green wald Prize of $25 in 
gold to Miss Ida E. Fretz, for the highest 



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52 



THE TRAINED NURSE AND HOSPITAL REVIEW 



average in practical nursing for the same 
term. 

The Rosalie Feustmann Prize of a nurse's 
emergency bag, to Miss Margaret G. Breslin, 
who showed the greatest efficiency in the 
management of a ward. 

The Sydney L. Feldstein Prize of $I0 in 
gold to Miss /Mabel C. Frost, for the highest 
general average in obstetrics. 

The David Kirschbaum Prize of $io in gold 
for the highest general average, to Miss Fanny 
Sydnor Hall, of the Intermediate class. 

The David Kirschbaum Prize of $io in gold 
to Miss Bluma Bayuk, for the highest general 
average in the Junior Class. 

The graduates are: 

Miss Anna F. Axler, Miss Margaret 
Gabrielle Breslin, Miss Ethel Florence Cor- 
-nog, Miss Ida Estella Fretz, Miss Mabel Car- 
rie Frost, Miss Nellie Antonina Gealt, Mrs. 
Linda Hughes, Miss Mary Jacobs, Miss Alma 
Elizabeth Krieg, Miss Margaret Roeschen, 
^iss Rae Rubens, Miss Thetosco Arline 
Smith, Miss Helen Smulyan, Miss Agnes 
Elise Osborne and Miss Annie Wharton. 



The regular meeting of the Alumnae As- 
sociation of the McKeesport Hospital was 
held in the ladies* parlor of the Masonic 
Temple, Wednesday, April 6th, at 3 P- M. 
Nine members were present. After roll call 
the minutes of the March meeting were read 
and approved. Treasurer's statement accepted 
as read. A committee was appointed to ar- 
range for a new directory for nurses. After 
the transaction of other business the meet- 
ing adjourned to meet June ist. 



The regular meeting of the Alumnae As- 
sociation of the McKeesport Hospital was 
held in the ladies' parlor, Masonic Temple, 
June 1st, at 3 P. M All reports were read 
and accepted as read. The meeting adjourned 
to meet first Wednesday in August. 

Miss Flora Keith, graduate of the Class of 
1905, was married June 2d to Mr. George 
Norman. Mr. and Mrs. Normati will live in 
Elizabeth, Pa., until Fall. 

At the end of the Winter term, 1910, the 
following students received their diplomas at 
the Pennsylvania Orthopaedic Institute, Phila- 
delphia, Pa., in the Swedish System of Mas- 



sage, Medical and Corrective Gymnastics, 
Electro and Hydro-Therapy: 

Susanna Sinclair, Lettie V. Kugler, Elma 
Armstrong, iMary M. Crotty, Marion C. Wan- 
baugh, Anna Gebhart, Annabelle Shearer and 
Adrian Uilkens. 

In the Swedish System of Massage, Medical 
and Corrective Gymnastics and Hydro- 
Therapy, Kathryn H. Montgomery, Philadel- 
phia, Pa. 

Among the students taking the Spring 
course at the Pennsylvania Orthopaedic In- 
stitute, Philadelphia, Pa., are the following 
trained nurses: 

Miss Fannie Maria Brooks, Suanemin, 111. ; 
Miss Sarah H. Hanley, Bridgeport, Conn.; 
Miss Catherine A. Sproul, Cambridge, Mass. ; 
Miss Ethel Oriel Rea, Saginaw, Mich.; Miss 
Eva M. Rea, Saginaw, Mich.; Miss Clara B. 
Beauford, Menominee, Mich. ; Miss Margaret 
J. Foresman, Allenwood, Pa.; Miss Annie 
Freeman Tidy, Boston, Mass. ; Miss Katherine 
Stevenson, Owen Sound, Ontario; Miss Ruth 
Bennett. Peoria, 111.; Miss Hallie Cyrena 
Cord, Needles, Cal.; Miss Nellie Scott Byram, 
Cortland, N. Y., and Miss Mabel F. Gray, 
Winnipeg, Manitoba. 



The Nurses' Alumnae Association of the 
Woman's Hospital held its last Summer 
meeting at 922 Spruce street, Philadelphia, on 
June 8, 1910. 

The minutes and reports of the correspond- 
ing secretary and treasurer were read and 
accepted. The auditing committee made the 
semi-annual audit of the treasurer's books 
and found them correct. 

At the May meeting the Association 
endorsed the replies made by the State Board 
of Registration to the recent articles in the 
Philadelphia papers, attacking the Board and 
registered nurse and expressed this approval 
by directing that a letter be sent the secre- 
tary. Dr. Albert E. Blackburn, to this effect. 



On May 25, the commencement of the 
Nurses' Training School of the Woman's 
Hospital was held in Clinic Hall. This was 
tastefully decorated in yellow and gold. A 
class of ten was graduated. Each one was 
present to receive her diploma, which was 
presented by Miss Meta Biddle. Dr. Alice 
M. Seabrook gave a report of the school and 
presented four honor prizes to three of the 



ADVERTISEMENTS 



Wtien you write Advertisers, please mention Tub Tkainbd Nomsb. 



54 



THE TRAINED NURSE AND HOSPITAL REVIEW 



class. Addresses were made by Rev. W. H. 
Graff, D.D., and Dr. Margaret F. Butier. 
Miss Helen F. Greaney was to address the 
class in behalf of this association, but, being 
unavoidably absent, her paper was read by 
Miss Anna M. Peters. May 26 the associa- 
tion, as usual, gave a tea to the class. This 
was held at the Philadelphia Club for 
Graduate Nurses. The club rooms were pret- 
tily decorated with the school and alumnae 
colors and beautiful flowers. A pleasant, 
social afternoon was enjoyed by about fifty 
nurses and friends. 

Miss Elizabeth D. Slaughter gave an in- 
teresting report of the Associated Alumnae 
meeting in New York, in May. 

There was a committee appointed to work 
out plans for securing a nurse for playground 
or Summer school work in Philadelphia this 
year. 

After routine business the association ad- 
journed until October 12. 

+ 
Maryland. 

The first annual commencement and gradu- 
ating exercises of the Training School for 
Nurses of St. Luke's Hospital, Baltimore, 
took place June 6th in the auditorium of the 
Baltimore Business College, Charles and Sara- 
toga streets. Seven young ladies received 
diplomas. They were Miss Edna Heaton Bar- 
nard, Maryland; Miss Eva E. Gibson, Miss 
Maude Basilla Gray, Maryland; Miss Nellie 
May Hutchins, Maryland; Miss Emma Maley, 
Pennsylvania; Miss Bessie C. Maumaw, Miss 
Mazie May Snyder. The programme con- 
sisted of musical selections and addresses by 
Dr. Charles Leslie Rumsey and Mr. Addison 
E. Mullikin, of the Baltimore Bar. 
•Rev. Charles E Young, dean of Morgan 
College, offered prayer. The diplomas were 
conferred by Dr. William M. Pannebaker, 
president of the Board of Directors of the 
Hospital. 

During his address Mr. Mullikin paid an 
eloquent tribute to the personal characteristics 
of the late President William McKinley, 
who, he declared, was the "embodiment and 
personification of gentleness." A glowing 
tribute was paid Miss S. Elizabeth Hurren, 
superintendent of nurses, by Dr. Rumsey for 
her work in the hospital and with the nurses 
of the institution. 

After the exercises the Superintendent of 



the Training School and members of the 
graduating class held a reception at the 
Nurses* Home. 

+ 

Changes in Army Corpt. 

APPOINTMENTS. 

Ethel M. Baker, graduate Illinois Training 
School, Chicago; Florence R. Churchill, 
Westboro Insane Hospital, Westboro, Mass., 
and New York Polyclinic; Elsie C. Dalton, 
Philadelphia General Hospital; Marie E. Kil- 
coyne, Milwaukee County Hospital, Milwau- 
kee; Lyda Latham, City Hospital, Cincinnati, 
Ohio; Mary McEntee, Bellevue Training 
School, New York City; Lyda Rodgers, City 
Hospital, Cincinnati, Ohio; Margaret L. 
Todd, Bellevue Training School, New Yoric 
City; Callie D. Woodley, St. Louis Training 
School, St. Louis City Hospital, St. Louis, Mo. 

RE- APPOINT ME NTS. 

Virginia M. Himes, Government Hospital 
for the Insane, Washington, D. C, and New 
York Polyclinic; Mary C. Jorgensen, Troy 
City Hospital Training School, Troy, N. Y. 

DISCHARGES. 

Rose E. Abel, May 26, 1910; Hannah P. 
Morris, April 9, 1910; Millicent Stuart, April 
8, 1910. 

TRANSFERS. 

Pearle B. Beecher, from General Hospital, 
San Francisco, to Manila, P. I., May 5 ; Bessie 
S. Bell, from San Francisco to General Hos- 
pital, Ft. Bayard; Emma Rothfuss, from San 
Francisco to General Hospital, Ft. Bayard; 
Pamelia E. Tieman, from San Francisco to 
General Hospital, Ft. Bayard, N. M. 
Jane A. Delano, 
Superintendent Army Nurse Corps. 
+ 
North Carolina. 

The Slater Industrial and State Normal 
School for Colored People, at Winston-Salem, 
N. C, through one of its trustees, William A. 
Blair, vice-president of the People's National 
Bank of that city, makes an earnest appeal 
for aid in raising $12,000 needed to equip a 
training school for nurses. The State officers 
have offered $12,000 if the trustees raise an 
equal amount, and the negroes of the com- 
munity give their labor free, so that $1 of 
outside aid brings in actually $4 to the school. 
The trustees will appreciate any contribution, 
however small. 



ADVERTISEMENTS 



TYPES OF ANEMIA 



68 



PARASITIC ANEMIA 

is caused by the corpuscle-destroyins action of 
the malarial plasmoife or the devilahzing effect 
produced by infection with tape-worm, hook- 
worm or other intestinal parasite. After the 
removal of the cause 

'pept^/Wiv^ ((jttde) 

can be depended upon to renew, restore and 
revitalize the vital fluid, without causing diges* 
tive irritation or constipation 



IN ll-os. BOTTLES ONLY.— NEVER SOLD IN BULK 

Sampl«a mod LItMtttnr* Upoa R«qa«at 

M. J. Breitenbach Co., N. Y., U. S. A. 



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Pluafelao 



ic Chut will ho 



to maw 



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Z 



A Drink in Fevers 



A teaspoon of Horsford's Acid Phosphate added 
to a glass of cold water makes a cooling and re- 
freshing acidulous drink for the patient during con- 
valescence from typhoid and other febrile condi- 
tions. 

Its superiority over Dilute Phosphoric Acid, or 
any other acid, is due to the fact that it contains 
the phosphates of calcium, sodium, magnesium 
and iron, which means increased nutrition. 

Horsford's Acid Phosphate 

is more palatable and strengthening than lemon- 
ade, lime juice or any other acidulous drink. 

RUMFORD CHEIMICAL WORKS, Providence, R. I. 



' I"I ' I"I"I"I"I"I-I ' I r I-I '. | .. | .. l .. l .. : .. H .. l .. | .. | .. | .. | .. | .. H .. | . | .. i .. | .. |M| .. | .. | .. |n| .. | .. ; . | ,i | .. i .. | .. | .. i .. i .. s .. | .. i .. i .. ImI .. I i ImI - I - 1 ' I-I-I 

W'hen you write Advertisers, please mention Thb Tsainsd Nursb. 



56 



THE TRAINED NURSE AND HOSPITAL REVIEW 



The school is one of the most important 
negro institutions in the South. One of the 
citizens of Winston-Salem recently offered 
$5,000, if the trustees would raise the same 
amount, for the erection of a hospital to train 
colored girls as nurses. The trustees did raise 
the necessary $5,000, and the negroes gave 
their labor, whereupon the State offered $12,- 
000. Only part of the necessary money has 
been got by the trustees. AH contributions 
may be sent to William A. Blair, People's 
National Bank, Winston- Salem, N. C 

+ 
South Carolina. 
The bill for the registration of graduate 
nurses was passed at the last term of the 
Legislature. At the present reading of the 
bill the Board of Examiners is composed of 
medical men. The nurses of the State hope 
to accomplish an amendment of this reading, 
placing two qualified nurses on the board. 

+ 
Iowa. 
On the evening of May 14th, the Iowa 
Methodist Hospital Training School Alumnae 
Association, Des Moines, held its annual ban- 
quet at the Savery Hotel, the members of the 
1910 graduating class being guests of the even- 
ing. A program of toasts and music followed 
the dinner and letters from absent alumnae 
were read. Twenty-one alumnae were present. 
During the business meeting that followed 
the members of the association voted to edit 
a section of the Hospital Magazine, a monthly 
periodical published by the nurses and for 
the benefit of the alumnae of the Methodist 
Hospital. It was decided to establish a sick 
fund. 



That Iowa, may have nurses ready to send 
to the front to serve in any national emerg- 
ency, a Red Cross headquarters will be es- 
tablished at Fort Des Moines, all examinations 
to be in charge of the surgeon of the Sixth 
Cavalry. 

Miss Estella Campbell, treasurer of the Des 
Moines Registered Nurses* Association, has 
been named one of the five nurses in Iowa to 
have charge of the Red Cross nurse organiza- 
tion work in that State. The other members 
of the State organization are Miss Helen 
Peterson, of Sioux City; Miss Ida Neff, of 
Waterloo; Miss Anna Goodale, of Iowa City, 
and Miss Helen Balcum, of Dubuque. 



The graduating exercises of the Nurses' 
Training School of the Iowa Methodist Hos- 
pital, Des Moines, Iowa, were held at the First 
Methodist Church on Friday, May loth, fif- 
teen nurses receiving their diplomas. 

Miss Lucretia Hayes, of Des Moines, who 
has done private nursing in the city for some 
time, has taken* up her new duties as super- 
intendent of nurses in the Aberdeen, S. D., 
Hospital. May 3d, the evening previous to her 
departure. Miss Anna Bailey gave a farewell 
party at her home, 79 Eighteenth street, for 
Miss Hayes. Thirty physicians and nurses 
were present and enjoyed cards and dancing. 
A buffet luncheon was served by the hostess 
and the evening was highly enjoyed by the 
guests. 

Kansas. 

The graduate nurses of Wichita, Kan., met 
at the Wichita Hospital and organized a 
graduate nurses' association on the night of 
May 26th. The object of the association is 
to help to procure State registration for 
nurses, to elevate and maintain the standard 
of nursing, to promote goodfellowship among 
the nurses and so extend sympathy and aid 
to those in trouble. 

The following officers were elected: Miss 
Alma O'Keefe , president; Miss Margaret 
Davidson and Miss Nellie Pyle, vice-presi- 
dents; Miss Josephine Winters, secretary, 
with Miss Amy Smith, treasurer. 

Much enthusiasm was shown by those pres- 
ent and it is to be hoped that the Association 
will grow and prove a success in every way, 
as it is something long needed in this city. 



The Eleventh Annual Commencement exer- 
cises of the Wichita Hospital and Training 
School for Nurses were held May 6th, at the 
Trinity M. E. Church, West Wichita. The 
following nurses graduated: Misses Emma 
Neith, May Hodges, May Fetrou, Sarah Jor- 
dan, Nellie Pyle, Rhea Dickson, Elizabeth 
Morain, Sophia Dibble and Lieuthenia Ander- 
son. After the exercises a reception was held 
in the nurses* parlors at the hospital for the 
graduates and their friends. 



The Red Cross Hospital Training School 
for Nurses held commencement exercises 
Monday evening, June 6th, at the Tabernacle 



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1 



Therapeutic Dependability- 



the unfailing sccomplishment of 
d^nite physiolc^c results— -has won for 



r Gray's Glycerine Tonic Gomp 

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functional debUi^. q When other tonics fail or are 
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GLYCERINE TONIC COMP. may be freely used with 
the constant assurance that its effects will ever be re- 
«to«^tive and reconstructive— never harmful or injurious. 




StmpUs »nd lOtrtiarc on rtqaesf. 



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Wfa«a jrou WTIU AdvartlMi*, plau* maatlon Tbi TiAnoD Nnm 



58 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Baptist Church, Kansas City. The programme 
was made up of musical selections and an ad- 
dress by Rev. Homer M. Cook. Dr. H. C. 
Andersson presented diplomas to Miss Feme 
Fleming, Miss Margaret Cunningham, Miss 
Stella Nesbit, Miss Mercedes Bowen, Miss 
Florence Millheisler, Miss Maud Smith, Miss 
Lillie Walker and Miss Helen Peacock. 



Colorado. 

The class of 1910 of the Minnequa Hospital 
Training School for Nurses held graduating 
exercises on the afternoon of May 24th, at 
Casa Vivicnda, Minnequa Hospital, Pueblo. 
Diplomas were presented to Effie Elizabeth 
Hall, Elsie Louisa Fischer, Annie Elizabeth 
Williamson, Anna Elizabeth Goodman, Kath- 
erinc Muriel Lincoln, Delia Alma Davis, 
Housie Ednar Campbell, Virginia Carnahan 
and Naomi Moore Kinsel. Dr. R. W. Cor- 
win, president. The address to the graduates 
was by Rev. Allan A. Tanner. There were 
both vocal and instrumental music. The 
school is under the direction of Miss Laura 
A. Beecroft. 

+ 

Married. 

Miss Eva Marshall, of Charleston, W. Va., 
a graduate of the Pennsylvania Orthopaedic 
Institute, Philadelphia, Pa., and formerly as- 
sistant in Dr. Barber's Sanitarium, Charles- 
ton, W. Va., has been married to Mr. E. Has- 
ton Jones, of Charleston. The wedding took 
place at Merion, Pa., and the young couple 
will be at home after June ist, at South Side, 
Charleston, W. Va. 



Miss Myrtle Coursey, a graduate of Mon- 
mouth Hospital Training School, and presi- 
dent of the Alumnae Association, was mar- 
ried April 20th to Mr. Arthur Edwards. They 
will make their home in Denver, Col. 



Miss Margaret Clark, a graduate of Mon- 
mouth Hospital Training School, was recent- 
ly married to Mr. Joseph Grier. They will 
make their home in Canada. 



Miss Carolyn Bond, of Clifton Forge, Va., 
was married recently to Mr. B. W. Balser. 



Resolutions. 

Miss Elizabeth T. Upjohn, a graduate of St 
Luke's Hospital, Utica, N. Y., class of i894t 
died at sea May 4th, 1910. 

Whereas, It has pleased God in His divine 
wisdom to remove one of our number 
whose life had been devoted to relieving suf- 
fering humanity, 

Whereas, All who were privileged to know 
her decree that their appreciation be suitably 
expressed, therefore, be it 

Resolved, That we, the members of the 
Alumnae Association of St. Luke's Hospital 
Training School for Nurses, of Utica, N. Y., 
realize that in the death of Miss Elizabeth P. 
Upjohn we have lost a faithful friend and 
earnest worker 

Resolved, That we herewith express our 
deepest sorrow and appreciation of her many 
good qualities and her faithfulness and loyalty 
to her profession. 

Resolved, That a copy of these resolutions 
be sent to her bereaved sister, The Traineo 
Nurse, The Jurnal of Nursing and be placed 
on the minutes of the Association. 

Anna Baker, R. N., 
.Annie Ren dell, R. N., 
Caroline Evans, R. N., 

Committee. 

+ 

Obituary. 

Dr. Elizabeth Blackwcll, widely known in 
England, where she was born, and in the 
United States, where she practiced, died at 
her home in Hastings, England. She was 
born at Bristol, February 3, 1821. 

Dr. Blackwell's parents emigrated to 
America in 1832. She taught in Kentucky 
and North and South Carolina, later studying 
medicine at Geneva University, and in Paris 
and London. 

In 185 1 she began practice in New York 
City, where she founded a hospital and medi- 
cal school for women. Returning to her 
native land she was placed on the English 
register in 1859 and practiced in London and 
Hastings. 

She founded the National Health Society 
of London and assisted in forming the Lon- 
don School of Medicine for Women. 



ADVERTISEMENTS 



PEAK'S ajpPOm fOR iUTQl OPHATON 

Hnii. etL 

Price, $1.?» 



UUl DQMEL ABDOMIUL BaJS 

a dcntDi of olheri dcgcribed in Citiloaue o( Belli 

Cbslic Stodiings, AnUtb, 
Knee (^ps, Trasses, etc. 



HOtPITALI FUIMUID COHPini 



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■ispM hnikn, hm' ten, tk. 
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HOSPITAI 



HOSPITAL PATTCI 

The"H-C;"Sy« 

nureei' annunciaton 
nuDciatw in the w 
which duplicate! all 
are reset only from 
patient, by a ptnh-t 

HO! 



which 
coiutnK 
and pn 
of tilL < 
button.) 
within I 
The 



'^i 



HOSPITAL SEM^ 

on the door casing ' 

of each ward, 

which shows, by 

meaiu of a red 

flag, just where a 

nurse is needed. 

The flag is reset by a slight 

pull on the chain. 

Send for Bulletin ISO N 



The Holtzer-Cabot Elec Co. 



V 



a wrlt« AdvertlMn, pleaae c 



ntlon TBI TmAitm Nvbrb. 



i^etD Bemetited ann ^Ippltameis 



For the Baby's Comfort. 

For infants, where the rectum becomes red 
and inflamed, keep the inflamed area covered 
with Unguentine and dust freely with fuller's 
earth. It will heal these cases in a remark- 
ably short time. 

+ 
Ergoaplol (Smith). 

In dysmenorrhea among individuals just 
entering on menstrual life, Ergoapiol (Smith) 
proves immeasurably more beneficial than 
such sedative agents as the bromides and 
viburnums, in that it exerts a marked and 
prolonged invigorating action on the entire 
reproductive apparatus. 

+ 
In Typhoid Fever. 

In typhoid fever there is nothing more im- 
portant than the question of the proper diet 
to be used, both in the progress of the fever 
and in convalescence. Horlick's Malted Milk 
has been so uniformly successful as a nutri- 
ent for such cases that it is endorsed by thou- 
sands of the medical profession. 

+ 
''Best Ever Used." 

Bristol, Conn., March 4, 1910. 
Messrs. Ogden & Shimer, Middletown, N. Y. : 
Gentlemen — Enclosed find 25 cents in 
stamps. Please send me a jar of Mystic 
Cream. I have used the sample you sent and 
consider it the best cold cream I have ever 
used. Yours sincerely, 

Emily M. B as sett, R.N. 
+ 
Hospital Registers. 

Give us an opportunity to furnish you with 
a list of hospitals to which we have supplied 
our various card register devices. Each and 
every one of these hospitals is a satisfied 
customer, willing to speak well of our register 
devices. 

Tell us what kind of register you want 
and we will submit a special drawing with 
estimate of cost, free of charge. 

The Universal Register Co., 

1409 W. Jackson Boulevard, Chicago. Ill, 



Arrow Brand. 

Arrow Brand Linseed Oil Soap is the best 
cleaner available for automobiles, carriages 
and other highly polished surfaces. It will 
not injure the most delicate finish. 

It is particularly valuable in the deanhig of 
carpets and rugs, as it not only removes dirt 
and grease spots, but also revives the original 
fresh appearance of the goods. 

+ 
Convulsions. 

In all cases of convulsions, immaterial of 
the cause, and in any other condition pointing 
to auto-intoxication, I flush the lower bowel 
with a solution of Glyco-Thymoline, one to 
two ounces to the quart of water. 

Glyco-Thymoline is always kept in my 
emergency grip. J. M. Drew, M.D. 

Fort Worth, Texas. 

+ 
All She Can Manage. 

New Rochelle. 
Dear Mr. Hallbeck: 

Your note received, and I thank you for 
your kind interest. I have already as many 
patients as I can manage. The "Hallbeck 
Method" is certainly thought favorably of in 
this town. Sincerely, 

Mary E. Faraher, Trained Nurse. 

+ 

Stomachic Stimulants. 

Baron Liebig, the eminent German chemist, 
said: ''It is easy to connect the origin of 
scurvy with the deficiency of phosphates in 
bread, and in other artices of food." 

Many persons require a "stomachic" after 
eating or drinking too freely. Horsford's 
Acid Phosphate is a grateful and effectual 
stimulant to the digestive organs and the 
system generally. ■ 

Not Incompatible. 

In an original article written for "Medical 
Reprints," Dr. George Selkirk Jones writes: 
"Another and most important subject for 
study will be that of incompatibility with 
respect to Antikamnia. At present I have not 
encountered this difl^culty, for in the treat- 



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INSTRUCTION IN MASSAGE 

THE SYSTEM YOU WILL EVENTUALLY LEARN 

Swedish Movemente. Medical and Orthopaedic Gymnastics 

T^rmi 3 Months Taltion F—^ $75.00 

Course In Electro-Therapy 

Tormi 2 Months Tuition Foo, $25.00 

Course In Hydro-Therapy In all Its Forms 

Tom I 6 Wooko .... Tuition Foo« $30.00 

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Fall ClMMt •MA Ia tw« MctloBts Smpfmht Sltt mmA MmyrwmhT 17lii» 1910 
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The instruction consists of daily clinical work and practical lessons on patients referred to our clinics from 
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All pupils attend clinics at scTcral city hospitals. Separate male and female classes. Payments can be made 
to suit your conrenience. Winter Classes open January loth. 191 1. Particulan and illustrated booklet on 
Maaaage upon request An aaHy appllcnlion fforndmiaslon la advlaabln. 

INSTRUCTORS 



Wm.Eosiet RoBBETSOir. M.D. (Professor of Medi- 
cine. Temple University). 

HowAKD T.KAasMBR.M.D. HInstructorsUniTersity 
HowamdA. SurroH. M.D. j of PennsyWania). 
Eldsidgb L.ELiASON»M.D.(Instr*t*rUniv.of Penna.) 

Louis H. A. von Cotzbausxn. Ph. G., M. D. 
(Graduate Phila. College of Pharmacy, N>cd. Dept. 
university of Penna..Penna. Orthopedic Institute). 

Wm. Ebwim. M.D. (Hahnemann and Rush Med. Col.) 



Max J. Waltbb (Univ. of Penna.. Royal Univ.. 
Breaiau. (Sermany. and lecturer to St. Joseph's. 
St. Mary's. Philadelphia General Hospital (Block, 
ley). Mount Sinai and W. Phila. Hosp. for Women. 
Cooper Hosp.. etc.) 

H BLBM B Bob SDOByp(Gym. Ins. .Stock holm* Sweden). 

LiLLiB H. Mabsball I (Pennsylvania Orthop»die 

Edits W. Khioht / Institute). 

Mabgabbt a. Zabbl (German Hospital, Philadel- 
phia. Penna. Orthopaedic Inatitute). 



Pennsylvania Orthopaedic Institute and School of 

Mechano-Therapy (laoogporAtoa) 

nil GrcM Street PHILADELPHIA, PA. MAX J. WALTER* SaperMeMleat 



IflfllfSOlfSFoOTV 

Jv»*cBorax lodine^Bran ^Al> 

ACT3 LIKE MAGIC 

40 Years the Stanclard of Efficiencye 

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Large cake, 25c. All druggists. Samples free on request. 

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WILBUR A. WELCH, Sole Dwtributor. 



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When you write Advertisers, please mention Thb Tbainbd Nubsu. 



62 



THE TRAINED NURSE AND HOSPITAL REVIEW 



ment of rheumatism, for example, with alka- 
lies and potassium iodide, the occasional use 
of antikamnia tablets appears to act as a most 
useful auxiliary, and a quiescent condition of 
nerve, brought about by the action of the lat- 
ter, appears to predispose toward a more per- 
fect metabolism." 

+ 
The Second Summer. 
Experience has shown that during the sec- 
ond or "teething Summer" weakened stomachs 
are strengthened, faulty metabolism is correct- 
ed, fatigued heart and circulation is sup- 
ported, and many a tired, worn-out nervous 
system is restored to its proper tone by the 
systemic and intelligent use of small doses, 
20-30 drops, according to age, of Gray's Gly- 
cerine Tonic Comp. 

+ 
Which Will You have? 
Which will you have? Nurses' l)ills and 
receipts, record books, clinical charts, clinical 
records, urinalysis blanks, blood examination 
blanks, temperature charts, maternity charts, 
operation blanks, hospital history sheets, bed- 
side notes, diet lists — we have them all, and 
more. Send for samples and prices, 

Chas. a. Lawes & Co., 
302 Dearborn street, Chicago, 111. 

+ 
Take it With You. 
A bottle of Listerine m.'iy well be included 
among the supplies for the stateroom or rail- 
way carriage.* There is nothing at all com- 
parable to Listerine as a mouth-wash, in the 
morning or at any other time. Internally, a 
teaspoonful of it will often relieve the nausea 
caused by travel, and it also improves the con- 
dition of the stomach for the reception of 
nourisbment. 1^ 

Perfect Hypo. Syringe. 

The "Record" Hypodermic Syringe (.see ad- 
vertisement in this issue), is the only perfect 
syringe ever put on the market. It is al)so- 
lutely aseptic, no washer or packing, has a 
perfect adjustment so that every drop of the 
dose is administered, there being no leakage. 
Can be thoroughly sterilized, easily put to- 
gether, barrel accurately graduated, plunger 
fits and docs not get out of order. Never fails 
to work. Send for catalogue of this and other 
nurses' supplies to the Valzahn Company, 1629 
Chestnut street, Philadelphia, Pa. 



Retlnol. 

I want to thank you for the sample of Re.s 
inol Shaving Stick. I find it first class. I 
want to say that it is the only soap I can use 
or shall use in the future. I shave every day 
and my skin is as soft and velvety as a girl's. 
My son also uses it and many of my friends 
and patients. The Ung*t Resinol is all you 
can claim for it. L. Dawby, M.D. 

West New Brighton, S. I., N. Y. 

+ 
No Irritation. 

Lieberich found that a 5 per cent, solution 
of Roric Acid applied directly to the cells that 
line the interior of the stomach and intestine 
produced no irritation and exerted no injurious 
action whatever, while a 5 per cent, solution 
of conmion salt, he find.s, exerts an inflam- 
matory action on these mucous surfaces. 
Boric Acid is exceedingly simple in its ap- 
plication; it can be used as a powder or «n 
solution. 

+ 
New Features. 

The now celebrated Wocher-Baldwin Auto- 
matic (self -balancing) Operating Table, as 
made by the Max Wocher & Son Company, 
of Cincinnati, is now also made with a reai 
porcelain enamel top. The material is similar 
to the in.side of a modern bath tub, which re- 
quires less cleaning, and is always white and 
aseptic. Many new features have been re- 
cently added to this table. Send for free 
booklet, "How to Equip a Hospital.' 



tf 



The Bromides. 

The over-stinuilation of the cerebral func- 
tions from alcohol yields promptly to the 
soothing action of Peacock's Bromides, which 
will often prove to be a stand-by in cases of 
delirium tremens. In these patients in whom 
the commercial bromides should not be ex- 
hibited on account of their usual irritating 
action on a stomach already seriously aflfected. 
Peacock's Bromides will fully meet the re- 
quirements. 

+ 
Painful Monthly Periods. 

Many doctors presenile a combination o£ 
Dioviburnia and Neurosine (equal parts) to 
abate the pain and nervousness of Dysmenor- 
rhea, Dioviburnia acting as a reconstructor to 
the parts affected, Neurosine allaying the pain. 
resuscitating and toning the nervous system. 



ADVERTISEMENTS 



FhUadelphU Orthopaedic 

Hospital and Infirmary 

for Nervoos Diseases 



Tl- PHILADELPHIA C«THO- 
PAEDK HOSPITAL AND INFIRM- 
ARY FC» NERVOUS DISEASES, b 
vrliieli bulnictian in nauge, cumcliv* *ik1 
le-edncitioiwl grmnutici tui been gncB for 
fifteen jean, now piopoMi lo extend md 
enluge tb« tcope of dik >enching. and oCen 
■ count in iheae lubjecU n4iich il it believed, 
¥n& lbs ereal Tuielf and quutitj of mite- 
linl for Mieemtioa ud pnctien nt ibe c&- 
poid ef dw bo^ital, cBuot be eqnnlad m 
Ihii eoDntry. 

Doring die jev 1906 ibe Bomber of 
ttcabaenii pren in die oul-padenl deputmail 
bj pQpik in die nuMage and meifical-eierciK 
conne exceeded ten ^uiand. Bende* diit 
advanced pnpib bare opportnnilie* of gnrmi 
eeaeral and ipecial naiiage to patie&ta in die 
b(>i{Htal nnder nperrinan of die intmclon m 
die coune. 

Tbe nibjecli cBvered bj Am coon* will !a- 
clnde lattmction in die treatmenl by maw a ge 
of general diecsKi of nutridon, neuratdieDia, 
bytkiia, cboiea, elc„ and by nuiMage and ei- 
crdw in cerebral and rpinii paralyni, infan- 
tile pali7, tranmatie injnriet of die tpinal cord, 
diilocation*, ioini acHterion*, ditabHide) fol- 
knnug fnclnre*, bsnu. •can, etc; iprnal 
comtnre and odier poatural defonaidet, Ba[ 
foM, dub foot, contracture* and die handling 
ia bj pmciiion and co-ordi- 



Tb* UMtracdoB wiD occupy about Mven 
■Mnlli*, beginnini in October. 1909. Lecture* 
wiB U v«en bj Dr. I. K. Mikbell, Di. Wm. 
J. Ta^, Dr. a G. Davii. Dr. Frank D. 
DUMin and Dr. Wm. J. DraTton. Jr., while 
tbe pradiEal IraAing occi^iea from Area to 
four honn daily. 



Tlioaa deairooi of altering die clan, which 
wiH be bniled in number, ihonld tpfAj to the 
•BperiBieadeDt of die boepital, who will tend 
a circular widi delaili of the reqmremenl* for 
■dnuwica. The fee for diii conrte ia |I00. 



tbe ibera- 

peD&: uu> of EJectridty, niilable for pnpili. 
nuy be lakoi vndi die mechano-dieiapy or 

Thta courae tail four montha, and die fee 

1701 Sommer St, Phila., Pa. 



When you write Advertise 



One of above special bottles of 
Qlyco-1 bymoline will be sent 

FREE 
Express Prepaid 

to any Trained Nurse on appli- 
cation. 

We want you to know the value 
of Otyco-Thymoline. It stands 
on its merits. 

Mention thia Magazine, 
KRESS & OWEN COMPANY 
210 Fulton 9t., New York. 
se mention Thi Trained Nuksb. 



64 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Physicians can prescribe Dioviburnia and 
Neurosine with impunity, as these products 
contain no opium, morphine, chloral or other 
deleterious drugs. 

+ 
Made Right. 
The extract of cod liver oil used in the 
preparation of Hagee's Cordial of the Extract 
of Cod Liver Oil Compound is made under 
such conditions that the medicinally active 
principles of the oil are separated from the 
fatty materials without in the least changing 
their state of combination or solubility, so that 
even the most complex specific lecithine of cod 
liver oil is contained as such in the extract 
and transferred unchanged to the cordial. 

+ 
Robinson's Patent Barley. 

Nurses having once used Robinson's Patent 
Barley will find it very superior to all other 
barley preparations on the market. It has 
been the standard make for the last eighty 
years. Can be prepared in many ways for 
patients with delicate digestion, as well as 
easily prepared for use in baby foods. Send 
post card with name and address to James P. 
Smith, 91 Hudson street, New York City, for 
their book of recipes, "Delightful Dishes and 
Drinks." 

+ 
Long Continued Invalidism. 

A nutritious, readily digestible diet is the 
first and most important prescription, and then 
a general reconstructive, restorative and recon- 
stituent tonic, such as Pepto-Mangan (Gude), 
should be ordered. This palatable, non- 
irritant and promptly assimilable blood con- 
structor and hemoglobin creator will almost 
always assist materially in increasing the gen- 
eral force and vitality of the chronic invalid 
without disturbing digestion or causing con- 
stipation. 

+ 
Three Gallons of Breakfast Coooa. 

One-half a pound of Walter Baker & Co.s 
Cocoa, and and one-half gallons of water, 
hot, and one and one-half gallons of milk, 
hot. 

This should not be allowed to boil. Either 
make it in a large double boiler, or a large 
saucepan or kettle over water. Mix the cocoa 
with enough cold water to make a paste, and 
be sure it is free from lumps. Heat together 



the milk and water, and pour in the cocoa; 
then cook at least an hour, stirring occasion- 
ally. Elizabeth Kevixx Burr. 

+ 
Sal Laxa (8<harp« & Dohme). 

It is a conclusion based upon the experi- 
ence of physicians who have used Sal Laxa 
extensively and satisfactorily that this prep- 
aration possesses peculiarly active powers 
which make it an efficient combination for the 
scientific treatment of various gastro-intes 
tinal affections. 

Its therapeutic application will naturally 
suggest itself. Briefly summarized, Sal Laxa 
is clearly indicated in the treatment of hepatic 
torpor, "billiousness" with headache, furred 
tongue, loss of appetite, constipation, nervous 
depression, low spirits and sallow complexion 
due to over-feeding, sedentary or luxurious 
habits and want of exercise. 

+ 
Nervous Vomiting. 

In treating nervous vomiting we must not, 
of course, forget to treat any disease which 
is associated with it. To overlook this is to 
allow the patient to go along without correct 
treatment. In many of these cases, however, 
we cannot find any disease factor. Generally 
there is, however, sufficient symptoms present 
to make us know that there is hysteria. There 
is no remedy which can be compared with 
Daniel's Conct. Tinct. Passifiora Incarnata in 
overcoming hysterical manifestations or quiet- 
ing the nervous system. One merit of the 
remedy also is that it is in no sense dan- 
gerous and will not establish drug addiction. 

John J. Eagon, M.D. 

St. Johns, N. B. 

+ 
True Worth and Vitality. 

As the interest in pure food products grows 
among the mass of the people, those sterling, 
pioneer preparations put out by the Postum 
Company, Ltd., of Battle Creek— Postum and 
Grape- Nuts — show their true worth and vital- 
ity. The sales of these famous foods con- 
tinue to increase year after year as the value 
of Grape-Nuts becomes known as an all- 
round food base of ideal qualities; and Pos- 
tum continues to supply the demand for a 
wholesome, coffee-free beverage for the 
breakfast table. The latest product of the 
Postum Company, called "Post Toasties," is 



ADVERTISEMENTS 



20 Mule Team Products 

For tlie lluft»ry aid SicHoom 

BORAX is one of the mildest antiseptics 
known ; in fact it is comparatively the 
only one known that is wholly safe to use 
in the sick room. Therefore, it can be used 
in the place of more powerful antiseptics, 
which are frequently the cause of poisoning 

Borax can be used indiscriminately in the 
sick room for softening water with which to 
bathe the patient, and for thoroughly cleans- 
ing bed linen, soiled garments and utensils. 

A boric acid solution is cooling and soothing 
for the eyes, for inflamed cuticle or the mu- 
cous membrane. Boric acid spangles are the 
best to use for making a solution. Boric acid 
in a powdered form is unsurpassed as a dust- 
ing powder. 

SO Hule Team Borax, Borlo Aotd and Sp&o- 
rlM are all psoksd In convenient cai-tODi tor 
the nurse to handle. The 20 Mula Team 
Brand la alwsye a guarantee of purity. 

Write tor our "Mafia Cryttal" booklet— fret 
on application. 



PACIFIC COAST BORAX CO. 

4ew Yorit : : Chicago : Z- Oakland 



Help Wanted? 

Would a quiet, efficient and unobtrusive assistant be accept- 
able to you during the long, nerve-trying hours of duty — an assist- 
ant that would reheve you of one-half the routine part of your 

The R.R.R. helps for nurses will render you just such assist- 
ance — every one is a specialist in its own particular field, meeting 
every requirement of modem nursing. 

One of these helps is shown in this advertisement — 

The R. R. R. Thermometer Set— Mouth, 
Rectal and Bath Thermometers 

In a CombliMMon C»>e 

that will insure your readiness for all thermometer emergen- 
cies. It will PAY YOU to know about the R.R.R. method of 
replacing broken thermometers. 

The R.R.R. helps also include charts for every purpose — bed- 
side, maternity and T. P. & R.— and the READY REFERENCE 
REGISTER, the history of your own personal experiences. 

You are entitled to a free and complete set of samples of these 
"Silent Sick-room Assistants;" to get them just write "Please 
send samples of the R.R.R." over your name and address on a 
postaL Address the postal to 

THE READY REPERCNCE REGISTER 

Herald Building WATCRTOWN. N. V. 



When you write AdverUsers, pleaae meDtlon THa TaAINBD Nutai. 



66 



THE TRAINED NURSE AND HOSPITAL REVIEW 



made of white corn, rolled, flaked and toasted 
a delicate brown. With cream and fruit this 
dainty is a delight — easy of digestion and ap- 
petizing. 

+ 
"The Laxative De Luxe." 

The A])l)ott Alkaloidal Company, of Chi- 
cago, 111., claim for Thah/sen tliat il is the 
best phenolphthalcin-laxative produced any- 
where. That is a big contention, but a host 
of medical men stand ready to uphold it. If 
you arc unacquainted with it, we recommend 
that you write for the complimentaiy trial 
package oi the tablets offered in the current 
advertisement. 

Thalosen appears to be an out-of-the- 
ordinary laxative, and the samples will prove 
a revelation to those who know phenolphthal- 
ein only in its commonplace forms. 

One physician has described Thalosen as 
"the laxative de luxe." 

+ 
Harmless and Pleasant. 

To sum up the result of the analysis, it ca:i 
truthfully be said that Coca-Cola is a whole- 
some beverage, having a sustaining effect due 
to caffeine; that Coca-Cola is entirely free 
from cocaine and other injurious and danger- 
ous substances; that except the flavoring add- 
ed to give Coca-Cola a characteristic taste, 
Coca-Cola contains nothing in effect not found 
in tea and coffee. 

In the light of these truths, the common 
.sense of every fair-minded person must con- 
vince him that a glass of Coca-Cola is as 
harmless as a cup of coffee. Yours truly, 
(Signed) J. C. Peacock, 

Analvtical Chemist. Philadelphia, Pa. 

+ 

The Allwon Manicure Buffer. 

The latest, most practical and convenient 
novelty is the Allwon Manicure Buffer. A 
complete outfit to the last degree, all con- 
tained in the hollow body of the buffer itself. 
Its superiority over the ordinary buffer will 
be instantly appreciated when some of its ad- 
vantages are understood. 

There arc furnished with and compactly 
enclosed in the Allwon Manicure Buffer the 
following: One high-grade, imported, steel 
cuticle scissors; one duplex nail file, six 
emery boards, one orangcwood stick, one box 
Allwon nail lustre, one box Allwon nail salve 



and enamel. Price, nickel plated, $2.00; sil- 
ver plated, $2.50. Sharp & Smith, 9^ Wabash 
avenue, Chicago, III. 

•f 
A Modern Miracle. 

If you want to read something interesting, 
you should read Archdeacon Struck*s article, 
•The Worst Sunday I Ever Knew"— a mis- 
sionary journey through ice and snow with 
the temperature sixty degrees below zero. 

An abstract of this article and a handsome- 
ly illustrated catalogue of the Thermos Bot 
tie will be sent free of charge to any nurse 
writing to the American Thermos Bottle 
Company, 243 West Seventeenth street. New 
York City. 

+ 
Are You Up-to-Date7 

Are you sure your hospital is up to-dale? 
Has it the latest hospital signals and electric 
semaphores? They will save you much money 
in the long run, besides saving time and 
trouble from the moment they are put in, and 
consequently increasing the efficiency of the 
hospital service. 

If you are open to the reception of new 
ideas, write to the Holtzcr-Cabot Electric 
Company, Brookline, Mass. 

•f 
The Prompt Relief of Infantile Gastro- 
Inteatinal Disturbances. 

It is exceedingly gratifying to note the 
prompt amelioration of infantile gastro-in- 
tcstinal disturbances that generally follows 
the systematic use of this well-known and 
time-tried nutrient — Ncstle's Food. 

Nestlc's Food is a scientific product that 
not only embodies the highest degrees of 
quality, purity, uniformity and nutritive value, 
but one that holds the distinction of having 
successfully served the medical profession for 
over thirty-five years. The fact that Ncstle's 
Food has been so extensively employed by 
thousands of physicians from one end c»f the 
country to the other, during all this period, 
and often by men who are opposed in gen- 
eral to artificial foods, is the strongest pos- 
sible evidence of its real dietetic utility. 

Nestle's Food solves the great problem of 
successfully feeding and nourishing infants 
whose digestive and assimilative functions are 
weakened and unequal to bodily demands. 
The whole nutrition is improved. 



ADVERTISEMENTS 



m These 1 
r sturdy, tw 
j^ears and 
old, were 
winners a 
baby show 

Their tn 
Richard J. 
Moines, la 
" Before usi 
Food, my he 
nearly all tl 
rhej- began 
when they 
ESKAYS, 
had a sick da 

food ougl 



00 

ds of bab 
jrsed, or 



^gins to g 
Sskay's n 
e but sup 
ete devel< 
: experimi 
. The s( 



tirde ^Itsiliet'si JBesik 



Ci)e CtaineH puttie anti 

A MonlMy Magazine Devoted to Trained Nuiting at' 
Private Practice and in the Hotpitab of the CouaA^ 

Editor 
ANNETTE SUMNER RCS2 

LAKESIDE PUBLISHING COMPANY 

PUBUSHERS 
OFnCE--1M-ll6 Eait 28th St. New York City 

THE TRAINED NURSE 

hat no free circulation. Its price is $2.00 a year, and 
it is worth Ik It is publiihed in the interest of the 
profession, screens no swindlers* putfs no humbugs, 
and docs not take half ittspace to teU how good the 
other half is. 

Annual Subscription, post-paid * . $2.00 

Single Copies .20 

BmUrtd as tscond-ctata mattgr mi iks Nrw York P»si 
OMct% March I4ih, tgoi* 

IMPORTANT NOTICE.— Those of our subscrib- 
ers who wish to notify change of address must send 
suth notification in order that it may reach the pub- 
Sishers not iaUr than the 20th of the month before 
publishing; otherwise the change cannot be made. 

COMPLAINTS for non-receipt of copies or requests 
for extra numbers must be received on or before 
the 10th of the month of publication; otherwise 
the supply u apt to be exhausted. 

TO CONTRIBUTORS.— We pay liberaUy for all 
Original Articles. 

Exclusive publication mvalt be insured to all 
contributions offered to the Editors. Rejected man- 
uscripts will be returned if stamps be sent for this 
purpose. 

Exclusive publication not required for contribu- 
tions to Nursing World Department. 

Illustrations for articles are particularly solicited. 
An expense for drawing plates, etc., will be borne 
by the publishers. 

No responsibility is accepted by the Editors or pub- 
lishers for the opinions of contributors, nor are they 
responsible for any other than editorial statements. 

Books and monographs will be reviewed promptly. 

Short, practical notes upon personal experiences 
or brief reports of interesting cases, with resulto 
from remedies, new or old, will be welcomed. 

The Editors and printers will gready appreciate 
die courtesy of having all manuscript typewritten; 
or, if this is impossible, clearly written, great atten- 
tion being given to proper names and medical terms. 

Copyright, 1910, by Lakeside Publishing Company. 



Important Notice. 

Every nurse who sees this is requested to 
look for our great Prize Offer, which will be 
found two right hand pages further back 

•f 

Acknowledgments. 

We beg to acknowledge receipt of the fol- 
lowing books, which will be reviewed as soon 
as possible: 

Light Therapeutics. A practical manual of 
phototherapy, for the student and the prac- 
titioner, with special references to the incan- 
descent electric-light bath. By J. H. Kellogg, 
M.D., superintendent of the Battle Creek 
Sanitarium, Battle Creek, Mich. For sale by 
Lakeside Publishing Company. Price $2.50. 



Prescription Writing and Formulary, con- 
taining 1,043 prescriptions. By John M. Swan, 
M.D., Associate Professor of Clinical Medi- 
cine in the Medico-Chirurgical College of 
Philadelphia; Instructor in Clinical Pathol- 
ogy and Tropical Medicine, Philadelphia 
Polyclinic and College for Graduates in Medi- 
cine; Fellow of the College of Physicians of 
Philadelphia. For sale by Lakeside Publish 
ing Company. Price $1.25. 



Pocket Therapeutics and Dose-Book, with 
Classification and Explanation of the Actions 
of Medicines; Doses in Troy Weight with 
Metric Equivalents, etc., etc., etc. By Morse 
Stewart, Jr., B.A., M.D. Fourth edition, re- 
written. For sale by the Lakeside Publishing 
Company, 114-116 East Twenty-eighth street. 
New York City. Price $1.00. 



Preparatory and After Treatment in Operat- 
ize Cases, by Herman A. Haubold, M.D., 
Clinical Professor in Surgery and Demon- 
strator of Operative burgery, New York Uni- 
versity and Bellevue Hospital Medical Col- 
lege, New York; Visiting Surgeon Harlcra 
and New York Red Cross Hospitals, New 
York, etc. With four hundred and twenty- 
nine illustrations. An important work of 650 
pages. Price $6.00. 



ADVERTISEMENTS 



r\ESPIT£ the bet that the therapeutic 
^ Tilue of Ergoapio] (SmiUi) it M <le- 
OBvdy ertaUithed that it ii now the mott 
(steuivelj employed agent of itt datt, it it 
%rorthT of mention that the >iq>enoritr of the , 
product b due to the tpecial fonn of itt chief 
conttituent, a[»ol, and the exceDent quaH^ 
of iti oUier componentt. i 

""THE a[Hol employed in die production of 

^ Ergoapiol (Smith) ditfen radically from 
the vaiioui commercial apiolt. in that it is de- 
cidedly more potent at a utero-ovaiion itimu- 
lant, yet doet not produce any ^>}ectionable 
by-etfeclt. This apiol, which it used exclu- 
sively at an ingredient of EJrgoapiol (Smith), 
ajid it not procurable in any other form, it 
manufactured by a proceti of our own inven- 
tion, whereby the drug it obtained in a true 
ttale. 

I T it became of the tpecial form of iti prin- 
^ dpal conttituent and the excellent quabty 
of itt other ingredientt that Ergoapiol 

(&iiilh) atfordt renillt which cannot be ob- 
tained from mixture* of "commercial ipeci- 
meni" of iti componentt; hence it it import- 
ant that the praclitioneT guard himtelf agaJntt 
tubtlitution whra prescrilNng the preparation. 



THE APPROVAL of the most EMINENT PHYSICIANS 
and its WORLD-WIDE ACCEPTANCE by the WELL-INFORMED 

BECAUSE itt COMPONENT PARTS are KNOWN to be MOST WHOLESOME 
and TRULY BCNETICIAL IN CTfEa, have given to 

SYRUP OF FIGS and ELIXIR OF SENNA 

the FIRST POSITION among FAMILY LAXATIVES and have led to its general 
usage with the most universal satisfaction. It cleanses the system gently yet 
promptly ; acts naturally and beneficially on the kidneys, liver and bowels; 
assists in overcoming constipation permanently. 

TO GET ITS BENEFICIAL EEEEaS, ALWAYS BUY THE GENUINE 

MANUfACTURED BY THE 

CAUPORNIA PIG SYRUP COMPANY 

THE GENUINE-SYRUP Of FIGS AND ELIXIR OF SENNA-IS FOR SALE, IN ORIGINAL PACKAGES 
ONLY, BY REUABLC DRUGGISTS EVERYWHERE 

One size Only Regular Price, AOc Per Bottle 

Wtifn you wTlta AdvwllMn, ploaig tnantion Tsa Taurai Nnaca. 



ADVERTISEMENTS 



i»»*"^ 



/iOTICEl IMVO'RTA/fTI 



HHE Third Edition, revised and enlarged, 
of Solutions^ by Edith M. Rice, is now 
on sale and selling fast. This very popular 
little pamphlet should be in the suit case of 
every nurse v^hen she goes to a case. 



Trice 20 Cents Tosfpaid 



Also in the form of a Wall Card for Hospital use, Price 25 Cents 



LAKi:SlDE PUBLISHING COMPANY 
114-116 i:ast 2ath StrMt NEW YORK CITY 



If Figures Talk. 



If figures really talk, we must certainly be- 
lieve that mechanical treatments of all de- 
scription are growing, not merely in the favor 
of the laity, but also in the favor of phy- 
sicians and hospitals. Almost ten thousand 
mechanical treatments were given in the last 
year at this institution alone, and nearly four 
hundred of our graduates have accepted in- 
stitutional positions either to take charge of 
the mechanical departments at hospitals and 
sanatoria, or as insructors to the nurses in 
the varoius branches of Mechano-Therapy. 

The Pennsylvania Orthopaedic Institute and 
School of Mechano-Therapy (Inc.), 1711 
Green street, Philadelphia, Pa,, offers to 
earnest men and women a cerfully prepared 
and most complete course in the Swedish 
system of massage, medical, corrective and 
educational gymnastics, electro- and hydro- 
therapy; also embracing the subjects of anat- 
omy, physiology and pathology as far as re- 
quired for this line of work. 

The students do not only get a thorough, 
practical and theoretical course in the 



branches mentioned, but are sent to the lead- 
ing hospitals of the city to give such treat- 
ments to patients in the nervous and ortho- 
paedic dispensaries. 

Upon completing the course, lasting three 
months, the institute assists its graduates in 
obtaining institutional positions as well as 
private work, and particularly in the last year 
the call for competent graduates has been far 
in excess of the number of available appli- 
cants. 

It is needless to say that this profession is 
dignified and remunerative, and any one in- 
terested in taking a course will find it to their 
advantage to inquire further into the matter 
by asking for an illusrated prospectus con- 
taining the necessary particulars. 

The Summer classes open on July 1?; the 
Fall class will open in two sections, on Sep- 
tember 21 and on November 17; the Winter 
class opens January 10, 1911. 

Kindly address all communications to Max 
J. Walter, Superintendent. 






VOL. XLV. 



NEW YORK. AUGUST. 1910. 



No. 2. 




ome ^totilems; in i^elatton tojlursies' 

Cratntns ^clioolfii* 

CHARLES STOVER^ M.D.^ AMSTERDAM, N. Y. 



^TT^HE relation of the physician to the 
-*• Nurses' Training School has been 
a limited one up to the present time. He 
has been a docile lecturer receiving his 
commission by grace of the trustees, sub- 
ject to the jurisdiction of the graduate 
nurse as superintendent; but so far as 
the physician's influence goes in the state 
administration of the Nurses' Training 
School it might be described in much the 
same terms as were used in regard to 
the snakes in the familiar history of the 
snakes in Ireland. The present control 
by the Regents has been brought about 
without the initiative of, and almost with- 
out any opposition by the medical profes- 
sion, and this in spite of the fact that 
the nurse has been most dependent upon 
the doctor for her vocational existence. 
The enviable distinction enjoyed by the 
trained nurse did not escape the observa- 
tion of Dr. Osier, who in one of his ad- 
dresses regretted that the nurse, in this 
country at least, had supplanted the med- 
ical student in the affection of the hospi- 
tal tnistees. It is to -be noted that in 
recent years the physician is being placed 
on hospital boards of management, and 
in the future it is possible he may regain 



his original privilege to influence the evo- 
lution of his trained assistant at the bed- 
side. In that earlier period of training 
schools from 1872 to 1904 that we might 
style the era of control by the hospital 
trustees, for this influence seems to have 
been dominant, there was a mercenary 
use of the nurse for private work that, 
while it added to the hospital revenue, 
also materially shortened the term of 
theoretical training. Let us concede that 
the primary consideration in organizing 
trained schools was not a sentimental one, 
but based upon economic considerations. 
This plan multiplied all over the United 
States must have averaged fairly well, 
for after thirty-two years, in 1904, there 
were 21,844 pupils in 867 schools in the 
United States among 1,484 hospitals. In 
this state alone there were 79 schools 
registered. [Thompson.] About this time 
begins what we may call the era of con- 
trol by the New York State Nurses' As- 
sociation. That organization in 1903 
sought the aid of this society to have 
passed the Nurses' Practice Act for the 
examination and registration of nurses. 
This was urged on by President Hopkins 
in his Inaugural, endorsed by a commit- 



♦ Read at the annual meeting of the Medical Society of the State of New York, at AVbany, Jan- 
uary 26, 1010. Published in New York State MedEcal Jtmrnah 



70 



THE TRAINED NURSE AND JIOSPITAL REVIEW 



tee on President's Address, made up of 
Drs. Roosa, Ely and Kraus, and approved 
by this society ; so that we are partly re- 
sponsible for the result of this legisla- 
tion, be it good or bad. The bill passed 
with no appropriation of funds for its 
application, and under its provisions was 
referred to the Board of Regents for ad- 
ministration. Here it was found so 
faulty and indefinite that it was held up 
for a year until subsequent legislation 
could remedy its defects. The first sylla- 
bus for guidance of Nurses' Training 
Schools in the preparation of students 
for Regents' examination, as provided 
for in the Act of 1903, was outlined by 
a committee on education of the New 
York State Nurses' Association in 1905. 
Since then it has been revised by the As- 
sociation and the Board o* Nurse Exam- 
iners, with the approval of the State 
Education Department. The last sylla- 
bus, No. 441, 1909, was prepared by an 
Advisory Council of Nurses' Training 
Schools, aided by the State Board of 
Nurse Examiners, and approved by the 
State Education Department. Therefore, 
we may not inaptly call this the era of 
control by the New York State Nurses' 
Association. Those who have been re- 
sponsible for the system so far devised 
for the education of nurses have pro- 
ceeded upon the assumption that the vo- 
cation of nursing is a profession in the 
sense that is recognized when you speak 
of the learned professions of the church, 
the law, and medicine. Upon this error 
it is unnecessary at the present time to 
dwell. It resulted that physicians lec- 
tured to nurses as they themselves had 
been lectured to when medical students, 
and nurse examiners asked questions on 
pathology and practice. It is not to be 
wondered at that megalocephalia became 
rampant among nurses. The danger of 



this sort of training has been discussed 
by Dr. Osier in one of his addresses at 
Johns Hopkins Hospital in 1897. He 
said, "With the fullest kind of training 
you cannot escape from the perils of half 
knowledge, of pseudo-science, that most 
fatal and common of mental states. In 
your daily work you involuntarily catch 
the accents and learn the language ot 
science, often without a clear conception 
of its meaning. I turned incidentally one 
day to a very fine example of the nurse 
learned and asked in a humble tone what 
the surgeon — whom I had failed to meet 
— had thought of the case, and she 
promptly replied that 'he thought there 
were features suggestive of an intra- 
canalicular myxoma,' and when I looked 
anxious and queried, 'had she happened 
to hear if he thought it had an epiblas- 
tic or mesoblastic origin,' this daughter 
of Eve never flinched, 'Mesoblastic, I be- 
lieve,' was her answer. She would have 
handed sponges — I mean gauze — ^with 
the same sang froid at a Waterloo." 

Whether the quality of nursing has 
been bettered since the control by the 
Board of Regents is an open question. 
It was expected that the high pressure 
system of that body would be applied, 
yet as a fact, the zeal of those who rep- 
resent the State Nurses' Association has 
outrun that of the Department of Educa- 
tion. Had the Board of Regents not re- 
fused their approval of their plans for 
entrance qualifications more than half of 
the 124 Hospital Training Schools in the 
State of New York would have been put 
out of business, and the present syllabus 
would be practicable only in large munic- 
ipal hospitals, and every graduate would 
be a specialist. One of the tendencies in 
the United States is to plan the course 
of instruction for the evolution of hos- 
pital administrators, ignoring the public 



SOME PROBLEMS 



71 



demand for ordinary and domestic 
nurses. Dr. W. Gilman Thompson states 
that "In 1908 there were in the United 
States 935 training schools for women 
nurses, with 22,100 pupils among 1,484 
hospitals, and an annual graduation ros- 
ter of over 5,600. At the present time 
there are more than 500 pupils in attend- 
ance at the schools in this State alone. 
Twenty-two thousand nurses constitute a 
good sized army. I think it a conserva- 
tive estimate to say that fully $10,000,000 
are invested in the housing of this num- 
ber of nurses. Recently two new nurses' 
homes have been opened in New York 
City alone, one for the Bellevue school, 
costing with its lands and furnishings 
over $700,000, and one at the Metro- 
politan Hospital on Blackwell's Island, 
costing, without the land, $350,000. In 
that city alone also within the past de- 
cade three other school buildings have 
been erected, one costing $500,000 and 
the other $300,000 or $400,000. The 
training of nurses involves to-day a very 
large financial outlay and the interest on 
the investment, together with the cost of 
maintenance, reaches several millions an- 
nually, but the community receives its 
financial return many times over in the 
value of the lives which are saved 
through the improved care which the 
sick receive." 

We are not seeking to dim the bright 
gems that adorn the crown of the modern 
nurse. She is established and we cannot 
do without her, but at this time we are 
discussing the system of nurse training, 
and may we not inquire whether for this 
enormous outlay the general public »s re- 
ceiving as much as it deserves ? Twenty- 
two thousand and one hundred nurses 
are engaged in hospital practice and 
5,600 annually turned into the stream of 
nurse practice. It is estimated that they 



do not remain in active service longer 
than ten years. Is it not wasteful to 
spend so much time in preparation for 
ten years' service? It is also calculated 
that even after this valuable education ?f 
graduate nurses, only 10 per cent, of 
the nursing outside of the hospital is 
done by them. Is this the best return 
that the hospitals can give to the public 
that supports them ? What has the nurse 
organization done to. meet the crying 
needs of the poor and middle classes for 
nursing at a moderate cost? Is it pos- 
sible to reconstruct our nurses' training 
schools so that more than 10 per cent, of 
the nursing that physicians are interested 
in securing for their clients shall be pro- 
vided for? Is it necessary to teach so 
much in order to train a good nurse ; or 
to put it another way, are not two years 
long enough for training? Ought not 
specialism in nursing be provided for by 
post-graduate courses in the large hos- 
pitals that are especially equipped for 
such work, rather than to load this bur- 
den upon the smaller hospitals of twenty- 
five to fifty b^ds, doing a most necessary 
and laudable work in their own field? 
Ought not a certain degree of autonomy 
be allowed the various training schools by 
the Regents so that local conditions can 
be met? Furthermore, carrying out the 
principle embodied in the constitution of 
this Society, namely: To direct public 
opinion in regard to the great problem of 
State medicine, ought not the 6,762 mem- 
bers of this Society to get in closer rela- 
tion to the educational department of the 
State and help it in its effort to admin- 
ister a law, originally no more sought 
after by the Board of Regents than by 
the physicians of this State? 

The nurse training school presents a 
more complicated problem in relation to 
hospital administration than does the 



72 



THE TRAINED NURSE AND HOSPITAL REVIEW 



medical school. It therefore should be 
considered from the standpoints of the 
various interests centering in the hos- 
pital, and these may be grouped as fol- 
lows : The public, the trustees, or gov- 
ernors, the medical staff and the nurses* 
training school. At the last annual 
meeting of the American Hospita* 
Association a special training school 
committee reported upon the possibility 
of standardizing the teaching of nurses. 
The report followed upon an extensive 
correspondence and repeated conferences 
with physicians, surgeons and training 
school committies of various associa- 
tions, hospitals and charity organizations 
in the Unted States and Canada. The 
result was not here definite owing to the 
present state of Gospel work and the 
various types and sizes of hospitals in 
city and town, and another committee 
was appointed to fully investigate the 
subject of nursing of people of limited 
means in their homes and the education 
of trained attendants for this work. 
Here are subjects of vital interest, not 
only to every physician, but also to his 
clientele, where a trusty helper is needed 
to carry out his instruction. Here, too, 
is the American Hospital Association 
formed by the trustees and superintend- 
ents of the leading hospitals of the 
I'^nited States and Canada, numbering 
nearly 500, and therefore representing 
the public, the governors, the physicians, 
and the nurses. Included in this associa- 



tion are members of the New York State 
Medical Society. The Hospital Associa- 
tion seeks enlightenment in formulating 
its report upon this subject in which we 
are all interested. Now, why should not 
this society of 6,762 members have a 
voice in this evolution of a more ideai 
nurses' training school; why should not 
this body also appoint its own representa- 
tives to advise the educational depart- 
ment of the State or at least to ratify 
the appointment, by the Chancellor of 
the Board of Regents, of the Medical 
Council ? It may not be generally known 
that such a body exists and that four out 
of the five Medical Councillors to the 
Regents are members of this society. The 
Nurses' Training School Council made 
up of an equal number, seems to have 
both ears of the Board of Regents, and 
so far as I can ascertain the advice v- 
the Medical Council is not sought. 

With the hope that our prerogative 
may be exercised wherever our interests 
are presented I will at the proper time 
offer the following: It is moved that 
the president appoint a special committee 
on Nurses' Training Schools consisting 
of h\Q^ members to confer with the State 
Department of Education when neces- 
sary ; to affiliate with other organizations 
in matters of common interests; to co- 
operate with the committee on legisla- 
tion ; and generally to advance the mutual 
interests of this Society and Nurses' 
Training Schools. 



Missouri. 

The Kansas City Association of Hospital sor, Kansas City, Mo.; secretary-treasurer, 
and Training School Superintendents has Miss Annie M. Lascy, German Hospital, Kan- 
been formed with the following officers: sas City, Mo. Organized June, 1906. Meet- 
President, Miss Cornelia E. Seelye, 4237 Wind- ings third Thursday of each month. 



Sour iltfe 3^ork 



B. A. WILKES, M.D., ST. LOUIS. 



VT EITHER by natural aptitude, nor 
-^ ^ by virtue of special preparation, 
do I claim ability to depart from the 
custom of first lauding the name and 
achievements of the sainted Florence 
Nightingale, and then fill in the remain- 
ing time with good advice about what 
you must do or not do to be a success. 
Hence to mitigate your disappointment, 
I will try to give you some food for 
thought, some desire for action, by point- 
ing you to the brightest star that shines 
in the firmament of a busy and useful 
life, and that is Success. 

There was an old preacher once who 
told some boys of the Bible lesson he 
was going to read the next morning. 
The boys, finding the place, glued to- 
gether the connecting pages. The next 
morning he read on the bottom of one 
page, "When Noah was one hundred 
and twenty years old, he took unto him- 
self a wife, who was" . Then turn- 
ing the page, "one hundred and forty 
cubits long, forty cubits wide, built of 
Gopher wood, and covered with pitch 
inside and out." He was naturally puz- 
zled at this. He read it again, verified 
it, and then said, "My friends, this is 
the first time I ever met this in the 
Bible, but I accept it as an evidence of 
the assertion, that 'we are fearfully and 
wonderfully made.' " 

HI could get you to hold such faith 
to-night, I could proceed cheerfully to 
the task I otherwise approach with more 
or less timidity. 

Your training here has only prepared 
you to successfully fight the battle of 



life and improve your opportunities. No 
matter what your natural gifts may be, 
you could not succeed in your work 
without having faithfully served this 
apprenticeship. 

Let what you have gained be an in- 
centive to something higher. You can- 
not rest on your laurels, no matter how 
hardly earned. You must press forward 
to the mark of the high calling. 

It is eager desire to attain excellence 
in their work that makes men and 
women successful. The love of excel- 
lence is the lodestar that leads the world 
onward. Nothing less than your best 
efforts will result in any lasting benefit 
to yourselves or to the community in 
which you live. It matters not if you do 
not reach your goal, for you will grow 
broader and higher and richer in ex- 
perience and knowledge through the try- 
ing. 

The modern trend of civilization is to 
advance and excel. If you are going to 
succeed, you must advance and excel, 
for "nothing succeeds like success.'' One 
of the greatest railroad men in America 
once said, "The most important thing 
about succeeding is to start right." 

To start right on this voyage of life, 
one of the your best assets will be cheer- 
fulness. 

The time will come in the progress 
of the world when we shall not have to 
depend on rich furnishings, costly tapes- 
tries and gold plate. Character will be- 
come so enriched in the upward growth 
of the world that the surroundings, how- 
ever costly, will be considered but a 



^Address to the Class of 1010. Missouri Baptist Sanitarium Training Sdiool for Nurses. Con- 
tributed to TBI Trainbd Nuesb. 



74 



THE TRAINED NURSE AND HOSPITAL REVIEW 



cheap setting of a precious life-stone. 
Cheerfulness is a potent factor of suc- 
cess. 

There is nothing which persevering in- 
dustry and unwearied and unremitting 
exertion may not completely and thor- 
oughly surmount. 

Despair of nothing, and never be cast 
down. If you ever wish to amount to 
anything never permit the idea to enter 
your mind that you are unlucky or less 
fortunate than other human beings. 

Discipline yourself never to acknowl- 
edge weakness. Deny that you are a 
weakling, that you cannot do what 
others have accomplished. 

Never talk, think or write of your 
unfortunate condition. Cut out of your 
life all thoughts that limit, hamper, 
dwarf, or darken it. These are the 
ghosts of fear. 

Resolve, that come what may, you 
will be an optimist. 

Believe in the final .triumph of right. 

You, amidst the fluctuations of your 
feelings, and of passing events, ought 
to resemble the ship which currents may 
carry and winds may impel from her 
course, but which amidst every devia- 
tion, still presses onward to her port with 
unremitting perseverance. 

In the coolness of reflection you ought 
to survey your affairs with a dispassion- 
ate and comprehensive eye, and having 
fixed on your plan, take the necessary 
steps to accomplish it, regardless of the 
temporary mutations of your mind, the 
monotony of the same track, the apathy 
of exhausted attention or the blandish- 
ment of new projects. 

"Look up, look up, when the shadows fall 
And the way lies dark before you, 

Hold fast to the faith that is best of all, 
And success will not ignore you." 

No human being ever made a success 



trying to be somebody else, no matter 
how great or successful that person 
might be. Success cannot be successful- 
ly copied; it is original; it is self-expres- 
sive. 

Your profession has made great ad- 
vancement and progress in the past few 
years. State Boards of Health and 
State Legislators have been impressed 
with your profession, its work and its 
importance, and are now making laws to 
govern and protect you by forming ex- 
amining boards and issuing a license 
authorizing you to practice your profes- 
sion and follow your vocation within its 
borders. 

The present is your time and oppor- 
tunity. It has been said, "He who is 
false to present duty breaks a thread in 
the loom, and will find the flaw when he 
may have forgotten the cause." 

Your life work is one of sacrifice and 
service to God and humanity. 

Your lecture course and bedside ex- 
perience have no doubt brought you face 
to face with the great responsibility of 
your chosen profession, and have taught 
you the beginning of a useful career. 

You may not all reach the highest 
pinnacle of fame, but you can all be use- 
ful women. 

"They talk about a woman's sphere as though 

it had a limit; 
There's not a place in earth or heaven. 
There's not a task to mankind given, 
There's not a blessing or a woe, 
There's not a whispered yes or no, 
There's not a life, or death, or birth. 
There's not a feather's weight of worth — 
Without a woman in it." 

You should all be strong in character, 
noble in thought and charitable in deed. 

In your ministration to the sick, you 
should at all times enter the sick-room in 
neat attire, fresh in appearance and 
pleasing in manner. 

Doctors seek the good nurses first The 



YOUR LIFE WORK 



75 



laity soon learns the value of a good 
nurse. The following is an incident of 
an Iriohman's value of a nurse: 

"Father Kelly says th* difference be- 
tween Christian Scientists an' doctors is, 
that Christian Scientists think they'se no 
such thing as disease, an* doctors think 
there ain't anything else. An' there ye 
ar-re." 

"What do you think about it?" asked 
Mr. Hennessy. 

"I think," said Mr. Dooley, "that if 
the Christian Scientists had some science 
and the doctors more Christyanity, it 
wouldn't make any difference which ye 
called it — if ye had a good nurse." 

Your training in the sanitarium does 
not deal merely with book learning and 
clinical methods; it carries with it the 



building up of character. To the building 
up of a fabric of personal education and 
of personal character, to the preparation 
of countless opportunities for good work 
in the world ; to happy, useful lives, and 
to the welfare of future generations, are 
you, the members of this class, dedi- 
cated. 

And when you go from this parental 
roof to enter upon this, your life work, 
I hope you will not forget your Alma 
Mater. Cherish the memory of the days 
and years spent here, and we hope you 
will always point with pride to your 
work and associations while in training. 

"And when the lessons of life are all over, 
And the Lord says our school is dismissed, 

May we all meet in Heaven together, 
Not one of our number he missed." 



Nebraska. 

The Nebraska State Board of Nurse Ex- 
aminers has three vacancies, on account of 
the resignation of all of the members. Miss 
H-ardwick resigned to be married, Miss 
Anderson because of leaving the State, and 
Miss Wollgast because of ill health. 

A new Board will be appointed soon by the 
Governor. Until that time, the nurses will 
suffer some delay on registration matters. 



association were present and seventeen mem- 
bers of the graduating class. 



The Nebraska State Association of Gradu- 
ate Nurses will be held in Lincoln, Neb., on 
June 28, 1910. An all-day session will be 
held and an afternoon picnic will be given at 
Green Gables Sanitarium. These meetings 
are held once in three months, and are very 
enjoyable. 

+ 
New Jersey. 

The Newark City Hospital Alumnae Asso- 
ciation held its annual reception for the grad- 
uating class at Davis Hall, May 24. A busi- 
ness meeting was first held, during which the 
new graduates were introduced and invited to 
join the society. About forty members of the 



Marriages of recent date among the mem- 
bers of the association are as follows: 

Miss K. Caraugh to Mr. Arthur Russell. 
Mr. and Mrs. Russell will make their home 
in Glen Ridge. 

Miss Sue Staufer to Mr. Frank Green. Mr. 
and Mrs. Green will reside in Roseville. 

Miss I. Buchnan to Mr. Woehmer. Mr. 
and Mrs. Woehmer will reside in East 
Orange. 

Miss Agnes Louise Hilt to Mr. Benjamin 
Keeler. Mr. and Mrs. Keeler are at present 
making their home in Newark, N. J. 



Personal. 

Miss Rose Konop, a graduate nurse, of Des 
Moines, Iowa, has had the rare privilege of 
a trip around the world with a party of tour- 
ists. Her friends have heard from her at va- 
rious points along the way — Hawaii, Japan, 
China, Egypt, etc. The party is expected to 
return shortly. 



fLtsi&om in Ci)etnt£(tt^ for finxatsi 



MINNIE GCX)DNOW, 
Superintendent Bronson Hospital, Kalamazoo, Midi. 



Supplies for Experiments, 

T^HE teacher of chemistry should 
-*■ bear in mind that experiments 
made before the class are far more im- 
pressive than any recital of text can pos- 
sibly be. It is therefore strongly advised 
that all experiments given in the follow- 
ing pages be actually made by teacher or 
pupils. The material for them is of the 
simplest diaracter, and will not cost 
more fhan a couple of dollars. It will be 
found aready on hand in most hospitals. 
There is practically no apparatus needed. 
The following is the list of things 
needed : 

2 oz. sulphuric acid, 
2 oz. hydrochloric acid, 
2 oz. powdered sulphur, 
Y2 dram iron filings, 
I oz. chloride of lime, 
y2 oz. tincture of iron, 
V^ dram solution silver nitrate, 
y2 oz. sugar of lead, 
V2 oz. powdered alum, 
I oz. washing soda, 
A few crystals of copper sulphate, 
A few small pieces of zinc. 

A Bunsen burner or alcohol lamp, a 
few test tubes and a glass rod should be 
provided. 

Lesson I. 

All matter, everything which we can 
see, handle, taste, smell, or deal with in 
any way by our senses, is divided into 
two classes, organic and inorganic. 

Organic substances are those which 
have a certain definite structure built up 



by the mystic force which we call life. 
They are usually products of plant or 
animal life. Wood, sugar, muscle, milk, 
etc., are examples. 

Inorganic substances are those struc- 
tureless materials which we call metals, 
minerals, earth, soil, etc. They are 
formed without the aid of animal or 
vegetable life. Salt, borax, iron, etc., 
are examples. 

Organic matter, we learn, is composed 
of cells. A cell is a minute portion of 
jelly-like substance with a thin wall 
about it, and a nucleus within. This, 
the simplest living structure we know, is 
quite complicated in comparison with a 
bit of mineral matter. Even a microbe 
or germ, small as it is, has a definite 
structure with parts unlike each other; 
whereas a piece of iron or gold is the 
same throughout. We resolve a cell 
into its simplest elements, and we find it 
composed of different kinds of material. 
We resolve a piece of iron into its 
simplest elements, and we find the same 
sort of material repeated over and over 
again. 

In imagination '-e divide organic mat- 
ter smaller and smaller in order to learn 
its final composition. By various pro- 
cesses we arrive at the conclusion that 
it is composed of substances similar to 
inorganic matter. We try to go further, 
but fail. We have not now at our com- 
mand any microscope or other instru- 
ment delicate enough to show us the 
smallest parts into which organic or in- 



I wish to acknowledge my Indebtedness to Dr. B. N. PJpler, of Kalamazoo, Mich., and to Miss 
Charlotte Aikens, of Detroit, Mich., for many helpful suegestlons. Also to Dr. E. C. Hill, of Den- 
ver, Col., for proof reading and corrections. 



LESSONS IN CHEMISTRY FOR NURSES 



77 



organic substances may be divided. \Vc 
can conceive that they might be capable 
of almost infinite division, yet we finally 
arrive at the ultimate bit, which cannot 
be further divided without destroying its 
identity. These smallest particles we call 
molecules. 

A molecule, then, is defined as the 
smallest portion of matter which can 
exist alone. 

We may ask if molecules are not ca- 
pable of division. The following experi- 
ments will suggest the answer. 

1. Dissolve a pinch of sugar in a small 
quantity of water. Add more water 
gradually, tasting often. It will be found 
that a very small quantity of sugar can 
be detected in quite a large quan- 
tity of water. This shows us that 
though the sugar be divided into par- 
ticles so small that we cannot see them 
with the most powerful miscroscope it 
is still sugar, the original substance. 

2. Place a small portion of cane sugar 
on a china dish. Pour over it ten or 
fifteen drops of sulphuric acid. The 
sugar presently turns yellow, then amber, 
then brown, and after a considerable 
time becomes quite black. This black 
substance resembles neither sugar nor 
sulphuric acid, but looks like fine char- 
coal mixed with some liquid. We find 
by further study that it is exactly this. 

3. Put some sugar on a tin plate and 
hold over a flame. The sugar browns, 
smokes, bubbles and finally becomes a 
charred black mass. 

We see by these two last experiments 
that the sugar is no longer sugar, but 
has become some other substance. Wt 
infer, therefore, that a change has taken 
place which has broken the sugar up 
into its constituent parts. These small- 
est parts we call atoms. 

An atom is the smallest portion of 



matter zvhich can exist in combination. 

This considering of matter as divided 
into molecules and atoms is known as the 
Atomic Theory. It is entirely theoreti- 
cal, but the facts of which we have any 
knowledge fit the theory. Scientists 
have adopted it, therefore, as a founda 
tion for the work of chemistry. 

What chemistry is. Chemists have, 
by long series of experiments, found 
that few substances are simple, but that 
very many are composed of two or more 
other substances. The study of these 
experiments and of the conclusions 
drawn from them is called chemistry. 

Chemistry is the science of matter, its 
properties and changes. 



Chemical and Physical Changes. 

If we heat water to the boiling point, 
it goes off into vapor or steam. If the 
steam be cooled, it returns to its original 
form. If we cause it to freeze, we have 
a solid mass, which we call ice. A 
slightly higher temperature returns it 
again to water. Such changes in the 
form of a substance are called physical 
changes. 

The first experiment with the sugar — 
the making of a solution — is another ex- 
ample of a physical change, for if we 
evaporate the water we may obtain the 
sugar in its original form. 

The second and third experiments ari 
entirely different matters, for in those 
cases we had formed an entirely new 
substance. Such a change occurring in 
the composition of a substance is called 
a chemical change. 

Experiments to Illustrate Chemical 

Changes. 

I. Mix powdered sulphur and fine 
iron filings. Use a magnet, and it will 
be found easy to separate the two sub- 



78 



THE TRAINED NURSE AND HOSPITAL REVIEW 



stances. Look at the mixture through 
a strong magnifying glass, and you may 
readily see particles of each substance. 
Put some of the mixture into a test tube 
and heat to redness. It becomes a mass 
in which neither iron nor sulphur can be 
distinguished, and which is neither one 
nor the other. By the first process we 
have a mechanical mixture; by the sec- 
ond, a chemical compound. 

2. Put a little ammonia water into a 
small glass vessel. Add a small quan- 
tity of tincture of iron. A dark red, 
rather heavy precipitate will be formed, 
which may be washed on fine gauze and 
examined by the class. 

3. Put some normal salt solution into 
a glass. Add several drops of a solu- 
tion of silver nitrate. Note the bluish- 
white precipitate formed. 

4. Put a spoonful of fresh chloride of 
lime into a tall glass vessel (a Mason 



jar will do), and pour over it a little 
50 per cent, sulphuric acid. Cover for 
a few minutes. A greenish-yellow gas 
will appear of a penetrating and disa- 
greeable odor. 

5. Blow gently through a glass tube 
into a bottle of lime water. The clear 
solution will presently become milky, and 
soon there will appear a fine white pre- 
cipitate which settles to the bottom of 
the bottle. 

The above experiments illustrate 
chemical changes. In the first, two 
solids — iron and sulphur — united to 
form a third solid. In the second and 
third, two liquids produced a third liquid 
and a solid. In the fourth, a liquid and 
a solid produced a gas. In the fifth, u 
liquid and a gas (from the breath) pro- 
duced a solid. These suggest the in- 
numerable combinations possible. 
(To be continued.) 



Ohio. 

The commencement exercises of the first 
graduates from the Wooster Hospital were 
held in the parlors of the hospital Thursday 
evening, June 23. The members of the class 
are Miss Elizabeth M. Aitkenhead, of Woos- 
ter, and Miss Viola S. Hixon, of Fredericks- 
burg. 

The rooms were beautifully decorated in 
roses, peonies, daisies, ferns and the class 
colors, black and gold. 

About 125 guests were present to witness 
the graduating of these young women, who 
have made many friends during their stay at 
the hospital who will wish them success in 
their life work. The following interesting 
program was given, with Dr. George W. Ryall 
presiding : 

Piano prelude, Miss Mary Nice. 

Invocation, Rev. D. A. Heron. 



Solo (selected). Miss Ethel Rockey. 

Accompanist, Miss Mary Nice. 

Address on Behalf of the Hospital Board, 
Mayor Feeman. 

Solo (selected), Miss Ethel Rockey. 

Address to nurses and presentation of di- 
plomas, Dr. G. W. Ryall. 

Benediction, Rev. D. A. Heron. 

Class pins were presented by the Hospital 
Board. 

A pretty incident took place at the close of 
the ceremonies. When nearly all had gone the 
little five-year-old daughter of Mr. and Mrs. 
Joseph Glenn was brought down. The little 
girl turned an inquisitive eye on many of the 
people, and suddenly all who were there 
became quiet, and Dr. Heron offered a short 
and appropriate prayer for the life and health 
and happiness of parents and the relatives of 
the child. 



Care of t|)e i^tump ^ftet ^ntputatton of 

tt)e Cxtremttted 

ALMA MARY HANNA 
Head Nurse Eves* Surgrical Sanitarium. 



^TT^HE nurse who assumes charge of 
-■• a patient after an operation of this 
kind, practically takes the patient's life 
in her hands for the first twenty-four 
hours at least, although the immediate 
danger is by no means over at so early a 
period, as it is well known that secondary 
hemorrhage may occur at any time up to 
the formation of a firm cicatrix. 

After the patient has been brought 
from the operating room he should be 
placed in a warm bed and well covered 
as in any other operation, but care 
should be taken not to have hot watei 
bags near the stump, which should be 
elevated in an easy position by means 
of a small pillow enclosed in a rubber 
case, over which the usual muslin pillow 
case is arranged. 

Do not let the end of the stump rest 
heavily on the pillow or any other sur- 
face. If it cannot be so arranged that 
the end may project slightly off the pil- 
low, then make a soft pad of absorbent 
cotton, which will serve the double pur- 
pose of a cushion to the extremely sen- 
sitive area and an absorbent of drainage, 
the amount of which will depnd on the 
locality of the section and vascularity of 
the part operated upon, as also upon thi 
presence of any provision made for 
drainage. 

Keep the stump free from the bed- 
clothes for the first twenty-four hours. 

It should be well exposed so as to be 
able to notice at a glance the sudden 
presence of a suspicious amount of blood 
upon the bandage. 



A tourniquet should be placed loosely 
around the limb above the knee if it be 
a leg, and above the elbow if an arm, 
with a compress directly over the course 
of the artery, so it can be tightened at 
a moment's notice should anything un- 
looked for occur. 

In private practice it is well to keep 
on a table near at hand, but covered 
from the patient's view, a basin of 
bichloride solution 1-5000, a supply of 
sterilized gauze, cotton and bandages, as 
also one pair sterilized scissors, tissue 
forceps, two or three pair hemostats and 
a hypodermic charged with a solution of 
morphine ^ and atrophine 1-150. 
Especially is this a practical procedure 
in the country with the doctor miles 
away and with no speedier means of 
locomotion than "Dapple Gray." 

After the patient has reacted from the 
anesthetic impress on him the necessity 
of being absolutely quiet. Do not evi*. 
allow him to talk, for the first few hours 
at least. 

Keep all curious and overly-sympa- 
thetic friends and relatives out of the 
room as much as possible, but if anyone 
must come in during the first twenty- 
four hours, spread a clean towel over 
the exposed stun^ to prevent a too sud- 
den realization of the deformity. 

Take the patient's temperature every 
four hours, and count the pulse not of- 
tener than once every hour at first. 
Oftener than this is liable not only to 
annoy but alarm the patient. 

Watch constantly, but unobtrusively, 



80 



THE TRAINED NURSE AND HOSPITAL REVIEW 



for any appearance of unusual restless- 
ness, thirst, yawning, sudden contracting 
of the pupils, blueness about the lips and 
cold, clammy skin. 

Should any one of these symptoms ap- 
pear, tighten the tourniquet at once. 
Draw it as tightly as possible, elevate 
the stump more and elevate the foot of 
the bed ; also give your liyjx) of morphine 
and atrophine. Even if you are not 
sure as to the presence of hemorrhage, 
give your patient the benefit of the 
doubt, as these measures could do no 
harm even if the alarm be false. 

But if you are certain, send at once 
for the doctor; if he lives at a distance 
and in the meantime your patient seems 
to be bleeding rapidly in spite of these 
measures, remove the dressings, use your 
tissue forceps and scissors to remove 
enough sutures to gain good access to 
the interior of the wound. Sponge out 
well with hot bichloride 1-5000 or normal 
saline and pack tightly with dry gauze. 
Use strips about three fingers breadth at 
first, then finish with a heavy packing of 
a broader piece; Over all place a firm 
compress of gauze and finish with a tight 
recurrent spiral reverse bandage (as- 
cending.) This will generally check the 
bleeding and can be left until the doctor 
reaches the patient, when the offendiffijg 
vessels can be caught and ligated. Do not 
at any time remove the tourniquet, even 
if it does not seem to be doing any good, 
as it would only cause delay, and as it 
can remain tightened for from four to 
six hours, it is just as well to leave it on. 

After this time or sooner if the patient 
be an old person or one with low vital- 
ity, it should be removed, as it is very 
liable to cause gangrene of the part by 
cutting off the blood supply. Wlifile 
waiting for the doctor, keep the palm of 
the hand pressed firmly over the dress- 



ing and have some one else in the room 
to attend to any other needs of the 
patient. 

There are other methods by which a 
nurse may treat secondary hemorrhage, 
but for a good many reasons and from 
experience, this is considered the best. 

1. You have your materials at hand. 

2. You can be absolutely sterile with 
all proceedings. 

3. The results are uniformly happy 
as regards checking the hemorrhage ami 
lack of infection and 

4. You have a dressing which ran r«»- 
main until a doctor reaches the patieni, 
and the longer the packing remains the 
more firmly the blood becomes coagu- 
lated within its meshes, thus making as- 
surance doubly sure. 

If no accidents occur during the pa- 
tient's convalescence, the stump should 
be treated as any other wound aseptic or 
septic, as the case may be. 

If aseptic, the dressings are usuallv 
not removed until after the first twen- 
ty-four Wours. If a drainage tube in 
used this is removed after thirty-six 
hours and left out. 

A word as to a method for facilitat- 
ing the easy and painless removal of 
these dressings, which are usually very 
copious, and by this time firmly adherent 
to the wound by means of dried blood. 

About one hour before the doctors 
arrival begin moistening the dressing 
with a solution of sodium bicarb one 
heaping teaspoonful to the quart of 
warm water. This solution is a safe 
antiseptic and further has the power of 
rapidly dissolving the dried blood in the 
dressing, whereas bichloride of mercury 
by coagulating the albumen in the blood 
renders the dressing more difficut to 
remove. 



CARE OF THE STUMP AFTER AMPUTATION 



81 



Remove the dressings carefully one 
piece at a time. 

Do not be in a hurry, and if the pa- 
tient is interested and not nervous, he 
should be allowed to watch the proceed- 
ings, as his interest in seeing the work 
done often displaces the apprehensive- 
ness of impending pain, which is perfect- 
ly natural when he is requested to "look 
the other way." Have at least one-half 
dozen sterilized towels or pieces of cloth 
to arrange around the stump, and after 
the soiled dressings have been removed 
cleanse the surface of the wound care- 
fully with bichloride 1-5000, dry thor- 
oughly and place on loosely a temporary 
dressing of dry sterile gauze, and over 
this adjust a sterile towel. Thus every- 
thing will be in readiness when the doc- 
tor arrives, who will then dress the stump 
in the manner he deems most suitable. 

If any unusual amount of pain ap- 
pears, after the first twenty-four hours, 
it usually, though not always, means pus. 



In such a case, the dressings may l)e 
moistened with bichloride 1-5000 and 
the doctor notified, who will then give 
further orders. 

It would be well to explain to the pa- 
tient in simple terms the reason why he 
is yet feeling pain and the presence of a 
foot or a leg, which has been cut oflf. 

Tell him that the severed nerves were 
once a continuous track, as it were, with 
smaller tracks branching therefrom, anrl 
running down the whole length of the 
limb, and has been so used to carrying 
messages of its former presence, and the 
sensations of pain and motion, that it is 
still returning them to the brain. 

Especial care must be given the pa- 
tient after an amputation of the leg 
when crutches are first used, as owing to 
his lack of strength and awkwardness in 
using crutches for perhaps the first time 
in his life, a fall is the frequent result 
with profuse hemorrhage if he be so un- 
fortunate as to strike the stump. 



Arkansaf. 

The Little Rock Graduating Nurses' Asso- 
ciation held their annual banquet at the 
Hotel Marion on June 5, 1910, twenty-five 
members being present and two visitors. This 
association is gradually growing and making 
rapid strides toward State registration. 



Minnesota. 

At the regular annual meeting of the 
Nurses* Alumnae Association of St. Barnabas's 
Hospital, Minneapolis, on June 7, the follow- 
ing officers were elected for the ensuing year : 
President, Miss Minnie Patterson; first vice- 
president, Miss Kate Reid; second vice-presi- 
dent, Mrs. T. H. Weld; secretary, Mrs. C. C. 
Pratt; treasurer, Miss Mabel Hedemark. 

The motion was carried unanimously that 
the superintendent of St. Barnabas's Hospital, 
Miss Harriett Hartry, be elected an honorary 
member of the association for life. 



The annual banquet of the St. Barnabas 
Nurses' Alumnae Association, of Minneapolis, 
was held at the Donaldson Tea Rooms on 
June II, at 7 p. m., at which the following 
program was presented. 

1. Address of welcome to graduating class, 

Miss Patterson 

2. Response for class Miss Watson 

3. Greetings from Montana, 

Miss Nellie O. Barsncss 

4. The Matrimonial Side of the Profession, 

Mrs. Simmons 



On Saturday, June 11, at 4 p. m., occurred 
the laying of the corner stone of the new pa- 
vilion of St. Barnalias's Hospital, Minneapolis, 
an addition which will extend the main build- 
ing, from Sixth Street, South, to Seventh 
Street, and increase its capacity to 150 beds. 



Climtnatt\)e antj Conte 3Bat|)0 anti ^et 

Cteatment for Coxemta 



MARY H. TUFTS. 



(Continued from July). 



^T^HE importance of well-directed ex- 
-■■ ercise in connection with hydro- 
therapy treatment, cannot be overesti- 
mated. Exercise not only encourages 
circulatory reaction, but heat elimination 
also. 

In persons able tx) take exercise, an 
amount of exercise sufficient to produce 
slight perspiration before the bath fa- 
vors the tonic effect of the application. 
Exercise should not be vigorous enough 
to induce excessive action of the heart 
or lungs, as a bath should never be given 
when these organs are over active. 

The best forms of exercise are walk- 
ing, Swedish gymnastics, Zander or me- 
chanical medical gymnastics. 

Persons who are unable to take active 
exercise may be prepared for the bath 
by massage, vigorous friction, or vibra- 
tions. 

The drinking of large quantities of 
pure water should be insisted upon with 
. the patient who has toxemia. This low- 
ers temperature, dilutes the blood, pro- 
motes evaporation from the surface, and 
excites the kidneys to increased activity, 
thereby encouraging the elimination of 
the toxins. 

In describing the eliminative treat- 
ments, massage must be given an im- 
portant place. I will merely speak of 
its effect upon circulation, elimination, 
nutrition, haematogenesis and phagocy- 
tosis. 

The influence of massage upon the 
lymph, circulation is marked. The lymph 



vessels drain the tissues of waste and 
toxic materials. Lymph channels are 
most abundant in the subcutaneous tis- 
sue and in the fascia, wliidi cover and 
lie between the muscles, so that these 
vessels are acted upon by massage. 

That massage and exercise of muscles 
greatly increase the flow of lymph, has 
been demonstrated repeatedly upon ani- 
mals. 

Massage stimulates all the functions of 
the skin, and promotes reaction* And it 
also promotes nutritive changes in the 
muscles. 

It promotes the secretion of digestive 
fluids, improves the appetite, promotes 
absorption of the products of digestion, 
and aids peristalsis. 

That massage aids the blood-naking 
process, has been demonstrated by the 
rapidity with which the number of red 
blood corpuscles and the amount of 
haemoglobin increase in the blood under 
this treatment, in cases of anaemia. 

Kellogg and other physicians skilled in 
these lines of treatment, claim that mas- 
sage increases the number of corpuscles 
in circulation, from about 25 to 50 per 
cent. Winternitz, of Vienna, and Mitchell, 
of Philadelphia, make like claims for it. 
But Winternitz teaches that this sudden 
increase of blood corpuscles is not due 
to a new production of blood cells, but 
the apparent increase in number is due 
to the bringing into the circulation a 
great number of corpuscles which have 
been retained in the large vascular vis- 



ELIMINATIVE AND TONIC BATHS 



83 



cera of the interior of the body, partic- 
ularly in the liver and spleen. 

Dr. Kellogg, by a series of experi- 
ments, has shown that under massage 
the blood shows an increase of from 3 to 
7 per cent, of red cells, and from 40 to 
80 per cent, in the white cells. The in- 
crease in the blood-count usually be- 
comes apparent within thirty minutes, 
and lasted from an hour and a half to 
two hours. 

If massage is used daily upon a person 
whose blood-count is deficient, a perma- 
nent increase may be noted from day to 
day. In this respect the effect of mas- 
sage seems the same as that of the cold 
application. 

Phagocytosis is the principal means by 
which the body antagonizes the invasion 
of foreign microbes, which always takes 
place in connection with infectious dis- 
ease. Microbes of different sorts, and 
even animal parasites such as the plas- 
mfodia of malaria, are captured and de- 
stoyed by the white blood corpuscles. So 
it is evident that massage, by bringing 
into the circulation an increased number 
of blood cells, must greatly increase the 
resisting powers of th-j body. 

In the case of exudates in parts which 
have suffered from inflammatory pro- 
cesses, the removal of the exudate de- 
pends upon its solution. This is effected 
by the white corpuscles, which actually 
digest the inflammatory products, thus 
setting them free to be carried away by 
the venous and l)miph currents. 

Hopadze has shown that massage is 
valuable as a regulator of the nutritive 
processes, by increasing the assimilation 
of nitrogenous food substances. It has 
also been shown that massage diminishes 
the weight of very fat persons, and in- 
creases the weight of those who are 
badly nurished. 



In the matter of elimination, the chief 
effects of massage are to encourage the 
activity of the liver, the kidneys, and 
the skin. 

Zander, of Stockholm ; Taylor of New 
York, and Kellogg, of Battle Creek, have 
devised many appliances for the giving 
of mechanical massage, which is a more 
or less perfect imitation of the action 
of the hands in the application of these 
treatments. These treatments are vari- 
ously styled mechanical Swedish move- 
ments, Zander, etc. The advantages of 
this mechanical treatment over the man- 
ual are in that they may be used for 
prolonged treatments by shaking or 
vibratory movements, which are exceed- 
ingly trying for the masseur, and cannot 
be maintained, at best, for more than a 
few minutes continuously. 

The functions of the great sympathetic 
nerve and of the abdominal ganglia and 
solar plexus are becoming better under- 
stood, and it seems clear that the appli- 
cation of strong vibratory or shaking 
movements of the abdomen may produce 
powerful physiological and therapeutic 
effects through the stimulation of the 
sympathetic. 

Professor Charcot, of Paris, has dem- 
onstrated the therapeutic effects of vi- 
bration in the treatments of organic dis- 
ease of the spine, which is one of the 
most intractable of diseases. This re- 
nowned physician had great confidence 
in the benefits to be derived from me- 
chanical massage. 

Mechanical vibration is said 10 l)c one 
of tihe most efficient means for relieving 
the great variety of paraesthesias from 
which neurasthenic patients suffer, such 
as numbness, formication, tingling, 
etc. 

It exerts a powerful influence upon 
the circulation, and restores the balance 



1 



84 



THE TRAINED NURSE AND HOSPITAL REVIEW 



of the circulation when it is disturbed 
by morbid reflex action. 

The so-called solar-ray is a substitute 
for the treatments by the sun baths. This 
apparatus is really a modification of the 
arc light, from which the powerful light 
and heat are refracted and reflected by 
a concave metal reflector. The rays 
from this apparatus not only influence 
jthe skin, but pass through the skin into 
the body, excitirg the cellj and lissui-s. 
The surface circulation is greatly accel- 
erated, free perspiration occurs, the 
heart's action is increased, and the activ- 
ity of tbe vital functions is promoted. 
The effects of the solar-ray seem practi- 
cally like those of the electric light bath. 
But a more radiant and intense n^at 
may be localized upon portions of the 
body with this apparatus than with any 
electric light bath yet invented. 

Treatments of this kind will give re- 
lief in the neuralgias and in neuritis 
more quickly than can be gained by any 
other treatment. 

In the year 1891 Dr. Kate Lindsay, 
of the staff of the Battle Creek Sanitar- 
ium, called to the attention of Dr. Kel- 
logg, superintendent of tlie sanitarium, 
the convenience of the ordinary incan- 
descent electric light wrapped in flannel 
as a means of applymg heat to the body. 
Dr. Kellogg had previously made use of 
the sun's rays in the treatment of chronic 
invalids, and particularly for the relief 
of spinal irritation. The observations 
of Dr. Lindsay in regard to the electric 
light led Dr. Kellogg to begin experi- 
ments with various kinds of apparatus 
designed to make the therapeutic applica- 
tions of electric light. This resulted in 
the development of the electric light 
cabinets and various devices for the gen- 
eral and local application of heat. 



The form of cabinet in general use 
for giving baths to the entire body con- 
sists of a compartment about five feet 
high, in which are placed from fifty to 
sixty incandescent lights. The cabinet 
is lined with glass or metal mirrors, to 
multiply the number of lights by reflec- 
tion. 

The cabinet is so arranged that the 
whole body of the patient, sitting up- 
right, can be exposed to the influence 
of the lights. And by means of 
switches and proper wiring the number 
of lights in use can be instantly con- 
trolled. 

The heat eflfects of the bath are de- 
rived chiefly from the incandescent films 
by radiation, and do not depend upon the 
heating of the confined air within the 
cabinet, as in vapor and other cabinet 
baths. 

By means of other constructions the 
incandescent light is localized upon the 
spine, trunk, joints and other parts. 
These appliances are so easily managed 
that they at once recommend themselves 
as a means of applying heat to the cuta- 
neous surface. The intensity of the ap- 
plications may be regulated by a rheo- 
stat, or by the number of, and candle- 
power of, the lights used. 

The electric light bath has proved to 
. be of greater value in the treatment of 
many diseases than any other means of 
applying heat, except water, and ad- 
mits of much more general employment 
than the Turkish, Russian, vapor or hot- 
air baths. And the bath, if properly 
UvScd, is decidedly tonic in character. A 
short application of the bath at full force 
for a time just sufficient to induce pow- 
erful stimulation of the skin, without 
provoking perspiration, is a most -ef- 
fective tonic. This effect may be in- 



ELIMINATIVE AND TONIC BATHS 



85 



tensified by instantly following the bath 
with a (X)dd spray, or cold mitten friction. 

The electric light bath is superior to 
all other means in the treatment of 
chronic riieumatism and all maladies de- 
pendent upon the uric acid diathesis 
owing to its ability to elevate the body 
temperature, while at the same lime pro- 
ducing vigorous cutaneous activity. The 
elevated temperature stimulates the oxi- 
dation of proteid wastes and augments 
vital combustion, while the increased skin 
activity carries off the waste products 
prepared for elimination. 

Recent teachings in physiology have 
been that the elevated temperature in 
febrile conditions is one of the methods 
of nature in combating the causes of 
disease. So the electric light bath may 
exerdse in many ^ases a strongly cura- 
tive influence by the elevation of the 
lx)dy temperature, thereby enabling it to 
produce antitoxins. 

In giving the salt-glow, salt of medium 
fineness and slightly moistened is used. 
This is applied to the whole surface of 
the body with frictron movements. Af- 
ter the application the salt, which adheres 
to the surface, is removed by the cold 
affusion shower or spray. Then the 
patient is quicldy dried and rubbed in 
the usual manner. The skin is hard and 
almost as smooth as marble after this 
application. In the case of feeble pa- 
tients a dash of hot water or a warm 
spray should be given just before the 
cold application. 

The salt-glow produces to an intense 
degree the circulatory stimulation of the 
brine bath, the sea water bath and the 
saline sponge. 

It is a tonic measure of high value, 
and produces valuable derivative effects. 
It is of special value for aged or feeble 
persons, whose heat-making powers are 



small, and in whom thermic reaction does 
not readily occur. 

It may be employed in cases of 
Bright's disease and diabetes, conditions 
demanding increasing skin activity, but 
contra-indicating the cold batiis. 

The physiological effects of irrigation 
of the intestine have been carefully stud- 
ied by Krull, Stadelmann and Kemp. 
The cold enema is believed to aid the 
liver by removing from the intestine 
large quantities of decomposing stuffs, 
with the microbes and the ptomaines and 
toxins produced by them. 

Intestinal irrigations afford great relief 
in a class of patients who suffer from 
atony and dilatation of' the colon, and 
who have nearly always a great accumu- 
lation of fecal matter. Autointoxication 
is really the cause of many of the dis- 
tressing symptoms from which such pa- 
tients suffer, and these symptoms usually 
disappear after the use of saline cathar- 
tics and the use of intestinal irrigations 
daily for two or three weeks. 

The cleansing enema should be given 
at a temperature of 92 to 95 degrees, 
and after this has been entirely dis- 
charged, a pint of water of the tempera- 
ture of 60 degrees should be introduced 
(and retained if possible) as a tonic for 
the intestine. 

Since so much is claimed by some phy- 
sicians for the so-called aseptic diet in 
the treatments of intestinal autotoxemias 
I will outline in a general way the die- 
tary measures often advised. 

Great advantages are claimed for the 
use of the lactic acid femients in intes- 
tinal putrefactions. It is said that the 
Bulgarian bacillus isolated by Metdini- 
koff at the Pasteur Institute of Paris has 
the faculty of destroying pathogenic in- 
testinal organisms. 



86 



THE TRAINED NURSE AND HOSPITAL REVIEW 



In the really aseptic dietary meats of 
all sorts, oysters, fowl, game, meat 
juices, beef tea, animal broths and all 
meat preparations are excluded, because 
of the presence of tissue wastes, uric 
acid and other toxic substances, together 
with ptomaines, the product of putre- 
factive change. 

Coarse vegetables (as cabbage, celery, 
lettuce, roots of all sorts, string beans, 
spinach and greens) must generally be 
avoided because their indigestibility leads 
to their retention in the stomach and 
colon, and thus encourages fermentative 
processes. 

Cauliflower, tender asparagus, green 
peas, purees of peas, beans and lentils, 
excluding the skins of these seeds, are 
allowable. 

Eggs in the form of eggnogs pre- 
pared without wine or brandy, soft 
boilcii eggs, soft custards prepared with 
sweetina, instead of cane sugar, may be 
taken freely when well tolerated. 

Raw fresh milk is admissible in a 
small proportion of cases only. Kumyss, 
Matzoon, dairy buttermilk and lactone 
buttermilk, cottage cheese, peptonized 
milk, junket and milk and lime water 
are allowed. 

Ripe fruits are allowed by some phy- 
sicians and loudly condemned by others. 



Those advocating fruits consider them oi 
value because of the germ-destroying 
acids which tihey contain. Cane sugar as 
a sweetening is admissible only in small 
quantities. They consider juice from 
fresh ripe fruits very wholesome. 

Preserved and pickled fruits and veg- 
etables must be discarded. 

Cereals are recommended as having 
high nutritive value and being easy of 
digestion when cooked at a sufficiently 
high temperature to thoroughly dextrin- 
ize the starch. 

Nuts are practically free from starch, 
consisting chiefly of fats and albumin- 
ous substances. They may be eaten 
fresh or crushed in the form of nut but- 
ter or in preparations such as protose, 
nuttolene, etc. 

An exclusive fruit dietary for a week 
at a time has been highly recommended 
by some. 

Others claim that intestinal asepsis 
can only be obtained by an exclusive 
dietary of acid buttermilk or kumyss. 
The patient takes three or four quarts a 
day for a week. Others recommend the 
use of buttermilk in connection with a 
selected mixed dietary. 

The breads that are generally allowed 
are graham, whole wheat, stale yeast 
bread and dry toast. 



Personal. 

Miss Annie W. Goodrich has been appoint- 
ed inspector of training schools for the Stale 
of New York. 



Miss Susan Heitzeniater has bcv.'n appointed 
superintendent of Nichols Memorial Hospital, 
Battle Creek, Mich. 



At a meeting of the Italian Red Cross, held 
in Rome on June 12, Miss Phyllis S. Wood 
was presented with a silver medal and a cer- 
tificate of merit for her services at Messina 
during the earthquake. Miss Wood is well 
known to the readers of The Trained 
Nurse, and her account of the disaster was 
given in our magazine. 



i^utnan ilatute anti a finxat 



H. RIVERS. 



T ONG years ago, when I was two 
•*-^ weeks past my probationary month, 
I found one evening my name posted 
on the bulletin board with directions for 
me to report for duty the next morning 
in the children's ward. 

So far my time had been spent in the 
women's medical ward, where I now 
felt as much at home as a cat in its gar- 
ret, but I indulged in no lamentations, 
receiving my marching orders with a 
good grace, since to do otherwise would 
have brought my nursing career to an 
abrupt termination. 

Unsuspected by me war clouds loomed 
large on my horizon, and all because 
there were strained felations between my 
old head nurse and my new one. The 
former, Miss A., on reading that same 
notice, remarked to the nurses with her 
that she pitied me for having to work 
under Miss B., which unfortunate 
speech being duly reported by some mis- 
chief maker to Miss B., she promptly 
retorted, "She'd see to it that Miss Riv- 
ers would wish she had never seen the 
children's ward." The next morning I 
was quite mystified at having myself and 
my greeting ignored. 

I finally mustered up courage to ask 
Miss B. what work sflie wished me to 
begin with. She turned away with a 
contemptuous look and flung at me over 
her shoulder, "There is always plenty of 
work for those who care to see it." As 
the other two assistants had begun on 
the bed-making, I then stepped to the 
third bed and started in — ^no more — for 
down swooped Miss B. on me and point- 



ing to the sand bags and extension ap- 
paratus — I learned later it was a Cox- 
algia case — ^asked: "Haven't you sense 
enough to know you are not competent 
to make this bed?" I begged her to tell 
me then which one I should make, but 
she intimated I must be hopelessly 
stupid if I had to be told that. Knowing 
I'd be called down if I skipped, I turned 
to the next bed, only to be again visited 
with her displeasure and practically told 
to move on, but not where to. I coold 
have hugged the little occupant of the 
fifth in line for being a convalescent, as 
I was allowed to finish his bed unmo- 
lested. After that all the beds which 
fell to me presented no difficulties — 
hence there were no more reprimands. 
It was only a respite, for all day long 
I could hardly start any work in peace 
and my position was rendered still more 
uncomfortable because the other assist- 
ants, taking their cue from the head 
nurse, let me severely alone. 

When the interne came to make his 
rounds I thought, "Now there will be a 
cessation of hostilities," but alas ! for in 
speaking to me Miss B. conveyed in her 
tones the impression that I was in dire 
disgrace, and finally the young doctor 
turned and gave me a look implying 
he, too, had joined the ranks of the 
enemy. 

By this time every child was regarding 
me with round-eyed wonder, and there 
was not even one friendly little face 
among them. This truly awful day came 
at last to a close. The last hours Miss B. 
and I were alone in the ward, the other 



88 



THE TRAINED NURSE AND HOSPITAL REVIEW 



two nurses being off duty. As the foot- 
steps of the night nurse echoed down 
the corridor — for this was before the 
day of rubber heels — I turned to bid my 
implacable head nurse good night. Then 
to my relief I saw victory was to be 
mine, for I had caught a gleam of light 
on her waist. Stepping up to her and 
looking her straight in the eye and point- 
ing to a tiny silver cross dangling by a 
royal purple ribbon from a button hole, 
I gently asked: ''When you treated me 
as you did to-day, did you say, */n His 
Name?" Very abruptly she turned away 
with "No, I didn't," but not quickly 
enough to hide a faint smile around her 
mouth which told me plainly her quick 
Irish wit recognized and appreciated the 
fact that I had taken the wind out of 
her sails completely. 

She was kindness itself the next day, 
and indeed ever after, and we became 
good friends, and I have so many pleas- 
ant recollections of her brightness and 
capabilities that my first day with her 
appears now merely as an amusing inci- 
dent. 

When I had been in training about a 
year and a half I was sent to another 
institution to widen my experience by 
nursing sick foundlings who, of course, 
were bottle babies. In connection with 
this institution was another — both being 
small affairs — where very young unmar- 
ried girls with their infants were re- 
ceived on leaving the hospital, cared for 
and trained in domestic work that they 
might become self-supporting and so 
rescued from a probable life of sin. 
They were in charge of a graduate nurse, 
Miss C. 

However, the third floor of the found- 
lings* building was utilized as a tem- 
porary hospital for any of these young 



mothers wHio might be ill or their babies 
ailing, and when such was the case they 
came under my care. 

One day the resident physician, a 
woman, told me slie was going to send 
me a girl, Maggie, from the other house 
because she insisted she was ill, though 
the doctor could not locate her trouble. 
She came over and behaved in a peculiar 
way which gave the impression she was 
playing off to avoid helping with the 
work; which was further confirmed by 
her eagerly assenting when the doctor 
asked her if she had a pain right across 
her fingers and also across hpr.toes. 

The nurseries were on the second floc^r 
and my quarters were just across the 
hall from them. One niglit I was sud- 
denly awakened by piercing screams and 
the night nurse calling, *'Oh, Miss Riv- 
ers, it's Maggie." She was standing in 
tlie hall above, and telling her to stop 
that noise instantly, I flew upstairs to 
settle with her for startling every one 
in this fashion, .myself included. 

She claimed she had screamed from 
pain, but could not locate it, and acted 
so silly and foolish I gave her a good 
scolding, told her it was folly to tell me 
that was a screain of pain, for I knew 
one when I heard it, and being unable 
to find any cause for her conduct, I 
tucked her in bed and sternly ordered 
her not to repeat the performance. 

Her case continued to baffle us and 
she was finally transferred to my own 
hospital. There I saw her in the women's 
medical ward, where the nurses said she 
was quite docile, had made no outbreaks, 
was no worse, but still a mystery. I 
saw her a week or two later. She was 
then desperately ill, indeed, dying, and 
her case had been diagnosed as abscess 



HUMAN NATURE AND A NURSE 



89 



of the liver, which the autopsy fully con- 
firmed. 

Poor child ! Up to the last her tongue 
had been unable to find the words which 
would give a hint of her trouble. 

As I stood looking down at the white 

drawn face on the pillow, how cruel 

that scolding now sounded in my ears, 

and I was so confident I knew a scream 

of pain when I heard it! I returned to 

my babies in a very sober and repentant 

frame of mind. 

* * « 

This work proved exceptionally inter- 
esting, sometimes presenting surprising 
contrasts. For instance, I was filled with 
pity when I stumbled on a young girl of 
seventeen whose ttars were falling like 
rain on the face of her tiny baby. Two 
hours later I was nonplussed to hear this 
same girl blithely singing, ''Where Is My 
Wandering Boy?" 

Late one afternoon Miss C. came to 
the nurseries and asked me to step over 
to my rooms. She looked worn and har- 
assed. It seemed Jane, one of the mo^^t 
promising of her girls, had behaved bad- 
ly all day. Besides being sullen and de- 
fiant and even impudent, her work had 
been so poorly done Miss C. had had to 
insist upon her doing it over and over 
until it was properly done, and finally 
Jane brought things to a climax by turn- 
ing on her seven months* old baby and 
slapping him. This was too much, and 
Miss C. felt Jane must be punished for 
her cruel act, but was too much used up 
with the day's conflict to trust her own 
judgment in the matter, and now ap- 
pealed to me to suggest how Jane should 
be dealt with. This I was unwilling to 
do until I had seen her face. 

As she was the one who prepared all 
the lime water, it was an easy matter to 



empty my jug and walk over for more. 

Handing it to her gave me the oppor- 
tunity I desired, and I did not look fully 
at her again even when thanking her for 
the fresh supply, as I did not want her to 
think I had noticed her unusual expres- 
sion. I next slipped round to Miss C.'s 
room to report and dropped on the floor 
at her feet, Turkish fas'hion. She use<l 
to say I was a rare lass for sitting on the 
floor! A sigh of relief greeted my an- 
nouncement of having thought of a way 
to punish Jane, which changed to a gasp 
of surprise when I said I wanted her to 
let me take Jane for a walk that evening 
after I was oflf duty. When she recov- 
ered her breath she exclaimed: "Why, 
that is no punishment; that is a treat, 
and she don't deserve it." "I know," 
was my reply, "that you agree with me 
in thinking we are here to help these 
girls get back to a normal condition. 
Jane looks to me not only sullen and 
defiant, but despairing, too, and if you 
actually punish her, you may make her 
desperate, and then there is no telling 
what trouble she may cause. Remember 
she is only a child herself, and has been 
shut up in this place for six months, 
where there are thirty-five crying babies 
besides her own, and perhaps tilings 
seemed unbearable to-day. Let me have 
her as I suggest, and I'll promise to 
walk her so far and so fast she will come 
back tired enough to go promptly to 
sleep instead of lying awake plotting." 
Unconvinced, yet distrusting herself, 
Miss C. consented to the plan, and right 
after supper sent Jane to my room, when 
she listlessly asked what I wanted of her. 
"It is going to be a glorious night, to- 
night, and I want to go for a long walk 
after I'm off duty, and I'd Ixi so glad to 
have you go with me — that is, if you 



90 



THE TRAINED NURSE AND HOSPITAL REVIEW 



care to — Miss C. says you may." Care! 
The look on her face made my throat 
feel very queer and as if the vocal chords 
had gone on strike. She stammered her 
thanks, but she had nothing to wear, 
having come to the institution with a 
shawl over her head. We were soon 
trying on some of my things and found 
a Spring jacket which fitted fairly well 
and a hat becoming enough not to make 
a guy of her. Then she hurried off to 
finish her sftlare of the work and care for 
her baby with a bearing which augured 
well for the success of the plan. 

In due time we sallied forth down the 
quiet, poorly lighted side street on which 
we lived. Tacitly leaving the institution 
and our life tihere out of the conversa- 
tion, we drank in the bracing air of a 
frosty October night, enjoyed the friend- 
ly stars and laughed quietly over some 



simple little happenings until we emerge I 
upon one of the finest thoroughfares of 
the city. Now we slackened our pace, 
lingering to look at the displays in the 
brilliantly lighted shop windows, and 
like veritable street arabs we selected the 
tjliings we should certainly come round 
and buy the next day. Beyond the shops 
were some of the finest homes in the 
city, and here we caught glimpses of 
beautifully dressed women on their way 
to their carriages. Altogether life seemed 
to hold possibilities of happiness in spite 
of sorrow and sinning. We were gone 
over two hours, and as Jane passed un- 
der the hall light her face spoke of re- 
newed hope and courage. At the break- 
fast table next morning I received a 
good account of her cheerful face and 
industry. 

(To be continued,) 



Philadelphia, Pa. 

The National Association of Colored Gradu- 
ate Nurses will hold their third annual con- 
vention in Philadelphia August i6, 17 and 18. 
A spacious hall has been engaged, where 
clinics and practical demonstrations will be 
given. It is hoped to establish a fund which 
will enable the association to start a cam- 
paign against tuiberculosis among colored peo- 
ple. 

Those desiring to help to make this conven- 
tion a great success should address Mrs. R. 
L. Williams, No. 127 North Fifteenth street, 
Philadelphia, Pa. 



McKeesport, Pa. 

The graduate nurses of the McKeesport 
iBospital held their annual picnic at Olympia 
Park, McKeesport, Pa., July 6, during the 
"Old Home Week" Friends from Elizabeth, 
Dawson, Greensburg, Uniontown, Monessen, 
Hawkins Station and East Liverpool helped 
to make the event an enoyable one. 



Colorado. 
The first annual commencement of the 
Weld County Trainitig School for Nurses, 
in connection with Greeley Hospital, was held 
in the First Presbyterian Church, Greeley, 
June 17. Miss Norma Carter, Miss Nancy 
Dill, Miss Susie Beattie, Mrs. Elsie C. Jones 
and Miss Minnie Raine received diplomas. 

+ 
Illinois. 

Commencement exercises of the Christian 
Training School of the Dr. White Sanatorium 
A\cre held on the lawn of the Oscar Taylor 
home. The beautiful surroundings of shade 
trees and flowers helped to make the occasion 
one of the most unique social functions in 
the city of Freeport. Miss Winnifred Taylor 
acted as hostess. Dr. J. T. White presented 
the diplomas, and the pins were presented by 
Miss Taylor, president of the Training School. 
The graduates were : Miss Asmus and Miss 
Wyman, of Monroe, Wis.; Miss Huntington, 
of Bishop, Cal, and Miss Zimmerman, of 
Freeport, HI. 



AN OLIVE GROVE, TIVOLI, ITALY. 
See arllcle. "An Ttalla:n Holiday." 



^n B^taltan i^olttiap 



PHYLLIS S. WOOD. 



0[^" unfailing interest and delight are 
the many excursions the leisurely 
traveller can take in the neighborhood 
of Rome. But lie must be leisurely. 

The hurried tourist, who, with limited 
time, dashes from one point to another, 
knows nothing of the charm of wander- 
ing through the surrounding country en- 
joying nature alone. Leave the guide- 
books at home. The Spring is the season 
and March the month, when the air is 
still fresh and keen, but the sun already 
warm enough to bring out the early 
leaves and blossoms, when the birds arc 
singing and wearing their brightest 
plumage and the sky above is limitless 
in its Italian blue. 

Choose just such a day and take 
the little steam tram that in one hour 
and three quarters carries you to Tivoli, 
the old Tibur of the ancients. Its ugly 
iron blackness shrieking its impertinence 
across the stately Campagna robs it of 
none of its beauty, of none of its ma- 
jesty. The plain is too vast, too exten- 
sive for such a little modern playtoy to 
make the awkward contrast one would 
fear. That little tram carries you rap- 
idly and you are glad of the facility it 
affords. But presently as we steam along 
we begin to detect the odor of sulphur 
fumes in the air, and with impatient ir- 
ritation we at first attribute them to our 
engine and sigh to think that after all 
modern facilities will mar our sense of 
the beauty around us. But no, the mal- 
odorous fumes also acquire interest 
when we are told that they issue from 
the sulphur springs that in association 



are in accord with all else that pertains 
to ancient history. They are the sulphur 
springs that Pliny calls the Aquae Atbu- 
lae, to which his contemporaries and 
others besides would resort for the cure 
of divers ailments. Half a mile to the 
north of the present station are the ruins 
of the Thermae, built by Agrippa. The 
springs are still in use and much fre- 
quented, but they are not as powerful 
and efficient as in ancient Roman times. 
The decrease in j)Ower can be measured 
within given limits by comparing the 
thin modern deposits with the ancient, 
Which have encrusted or altogether 
choked pipes, reservoirs and even bath- 
tubs. 

It is with feelings of shame that we 
look at the modern shabby little bath- 
house of the Aquae Albulae and picture 
in their stead the old Thermae, with 
their colonnades of verde antico sur- 
rounding mysterious depths of turquoise 
blue, marble and mosaic floors, basins of 
gilt bronze and precious marbles ready 
to receive the hot bubbling water, the 
whole surrounded and shaded by the 
woods dedicated to some health-restor- 
ing nymph. 

But with just time enough to set down 
visitors to the springs our little train 
snorts and fusses and is soon off again 
through the green undulating loveliness 
of the campagna, past the ruins of 
I ladrian's Villa and on toward the slopes 
leading up to Tivoli. 

These slopes are wooded with olive 
trees that, seen from a distance, give 
the hills the soft grey-blue tone so pe- 



AN ITALIAN HOLIDAY 



93 



culiar to them alone. The olive tree, 
with the vine, is the chief agricultural 
industry of the neighborhood, and is as 
remote in its appearance there as its 
earliest settlers. It was imported by the 
Pelasgians. In early Roman times it 



making industry gained ground, as it 
had begun to do over the greater part 
of Italy. It was in the year 945 that it 
began to be noticeable. In 1556 a census 
of the trees was taken and 75,000 found 
to be growing within the municipal 



VIEW OF THE CITY OF TIVOLI, ITALY. 



was not as extensively cultivated here 
as it is now. The sunny slopes over 
which we are now climbing were at that 
time occupied by gardens and pleasure 
grounds. With the abandonment and 
destruction of the many villas the oil- 



jurisdiction; 103,045 were numbered in 
1739; 126,000 in 1845, and 150,000 at 
the present day. Above a certain level 
the olive tree bears no fruit; its limits 
extend over a belt of limestone founda- 
tion from 500-1,000 feet above sea level. 



94 



THE TRAINED NURSE AND HOSPITAL REVIEW 



It seems as though the appearance it- 
self of the olive tree told us the tale of 
its genealogy. The grey, bent and 
crooked, twisted trunks and weird out- 
stretching arms, and the little crisp green 
leaf with its silvery sheen all speak of 
age and antiquity. 

At the summit our journey ends in 
the little piazza of the town. Tivoli it- 
self is only interesting for its pictur- 
esqueness, its associations and the water- 
fall. It was the favored pleasure resort 
of the ancients. Illustrious women 
graced it with their presence in the popu- 
lar belief that the climate was good and 
improved their complexion; a season 
spent at the waterfalls wonderfully clear- 
ing the skin. Tibur was the only place 
known to the ancients where ivory was 
not discolored or blackened by age. Tht 
hills by the river Anio were considered 
out of reach of the plague which periodi- 
cally visited Rome several times in one 
century, the habit becoming customary 
for the frightened Quirites to take refuge 
in rTibur at the first signs of the epi- 
demic, though the Tiburtines showed 
them scant welcome, at one time chasing 
them back to the stricken city with cud- 
gels, shouting: **Death to the Romans." 

Many famous names in mediaeval his- 
tory are familiar in Tivoli. Marguerite 
of Austria, the handsome daug'hter of 
the Emperor Charles V., widow of Ales- 
sandro de Medici, and affianced wife of 
Duke Ottavio P^arnese, nephew of the 
Pope, visited it in 1540. She was en- 
tertained in the Town House, the local 
noblesse making her stay agreeable with 
hunting, dancing and sports. Ciriaco 
d'Ancona, the first archaeologist and ex- 
plorer visited Tivoli in 1432; in 1460, 
Enea Silvio Piccolomini, the first 
learned tourist, visited there for a time 



for the purpose of study. Later on he 
became Pope Pius II. Pope Sixtus V., 
in 1482, brought into fashion again the 
use of Tivoli as a Summer resort. 
But in passing we must not for- 
get to mention Pirro Ligorio, the 
artist arc^haeologist of the sixteenth cen- 
tury. He it was who designed the 
Villa d'Este, which stands on the west- 
ern slopes of Tivoli, distinct and separate 
in interest to what the town affords. 
Ligorio's stupendous creation, adapting 
classic architecture and classic landscape 
gardening to the requirements of his own 
times, made this Tiburtine residence of 
Cardinal Ippolito d'Este one of the won- 
ders of the world. It has been given the 
highest place of honor among Italian 
creations of the same nature. The 
beauty of its site, its groves of cypresses, 
ilexes and laurel, its abundance of rush- 
ing water and thousand fountains all 
tend to make it the most fascinating spot 
in which to wander and dream. It is 
also from the river Anio that these 
fountains and streams are fed. 

This mighty Anio intersects subter- 
raneously the entire town of Tivoli and 
gushes forth through unexpected caverns, 
forming the many waterfalls pouring 
down the hillside. 

For centuries that river has flowed, 
and its sparkling waters have leaped un- 
disturbed over the cliffs of the moun- 
tain, but man's superior force is now 
being used to curb that strength to his 
own just needs. Tivoli's waterfalls, 
with no great detriment to their natural 
beauty, are supplying Rome with electric 
power and light. It is claimed that they 
produce the strongest power in the world, 
owing to the enormous height from 
which they fall, though their volume is 
exceeded elsewhere. 



€tittottallp Speaking 



An HI Advised Protest 

It is comparatively rarely that The 
Trained Nurse attempts to discuss Eng- 
lish nursing matters, for the situation 
and sentiment there is so confusing that 
injustice might easily be done. There 
are at least three factions in the nursing 
circle of that country, each presumedly 
working in the interests of nurses, and 
of the efficient care of the sick, each 
thinking its motives and methods super- 
ior to the others, and each striving to 
impress its particular ideas and ideals on 
the British public, and especially on the 
British Parliament. 

An occurrence of interest to some 
American nurses, and to some hospital 
people, inasmuch as it shows a signifi- 
cant tendency, which, though it has not 
yet conspicuously manifested itself in 
America, may do so at any time, was a 
meeting of some of the graduate nurses, 
some of the pupil nurses, and one of the 
former Matrons of St. Bartholomew's 
Hospital, London, called to protest pub- 
licly, apparently because a graduate of 
the St. Bartholomew's School for Nurses 
had not been appointed Matron to suc- 
ceed Miss Isla Stewart, who died a few 
months ago. The position of Matron in 
England corresponds to the principal of 
the training school, or the superintend- 
ent of nurses in this country. The Nurs- 
ing" Times (London) gives the following 
account of the meeting: 

"The appointment of an assistant matroii 
at the London Hospital to be matron at St. 
Bartholomew's, has roused much indignation 
among Bart.'s nurses past and present, and 



was the reason for a protest meeting held at 
the Medical Society's rooms on Tuesday night. 
Miss Maud Banfield, who was trained at 
Bart's, and has held the post of superintend 
ent of the Philadelphia Polyclinic Hospital, 
was in the chair. Among the speakers were 
Miss Helen Shuter, Miss Kingsford, Miss 
Cox Davies, and Mrs. Bedford Fenwick, and 
letters of sympathy were received from two 
governors of St. Bartholomew's Hospital. 
The speakers felt aggrieved at the appoint- 
ment cf a matron trained in a hospital which 
gave a certificate after two years' training. 
They contended that the idea of a bureau- 
cratic nursing system being introduced into 
"Bart.'s filled the staff with apprehension, ana 
it seemed as though those who thought for 
themselves and believed in self-government, 
would have no chance of professional promo- 
• tion. Resolutions were passed unanimously 
asking for a public inquiry into the methods 
of management of the nursing school, and 
also into the insanitary and dangerous condi- 
tio n of the nurses' home. Copies of the reso- 
lution were to be sent to his Majesty the 
King, as president of the hospital, to every 
governor, and to the members of both Houses 
of Parliament." 

To the spectator this action on the 
part of the nurses of St. Bartholomew's 
seems, to say the least, ill advised. To a 
great many people the chief question at 
issue is whether the governors of the 
hospital or a faction of the nurses of the 
hospital are to manage the institution, 
and there can be but one answer to this 
question. The resolutions attacking the 
sanitarv condition of the nurses' home, 
and the methods of management of the 
nursing school would seem to be partic- 
ularly ill-timed, and the question nat- 
urally arises. Why were these things not 
taken up during the regime of the late 



96 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Matron? The late Matron was in full 
sympathy with the registration leaders 
in England and America. The newly ap- 
pointed Matron presumedly is not. We 
have many boards of managers in 
America who will fully sympathize with 
the governors of St. Bartholomew's in 
this desire for a change of policy and sen- 
timent in the training school, however 
great the respect for those who have di- 
rected the work of the training school in 
the past, may be. In fact in a number of 
instances in which a change of super- 
visors in the training school had to be 
made in large American hospitals, the 
trustees have personally written us ask- 
ing to be put in communication with 
women suitable for training school man- 
agement, who were not given to run- 
ning to extremes, and who were not ac- 
tive in nursing politics. 

The graduate nurse who accepts the 
position of superintendent or principal 
of a training school has a responsibility 
for the influence which she exerts, which 
the graduate nurse in private life has 
not. She may have her own personal 
opinion regarding the politics of the 
nursing world, but she is paid to teach 
and manage nursing, not to strengthen 
any political party by influencing pupil 
nurses to ally themselves with it. The 
instructor in a medical school may have 
his individual opinions, which to him 
may seem important, but he is likely to 
find that he is open to censure if he 
uses his position as instructor to pro- 
mote ideas which those in authority are 
convinced are better kept out of the 
school. Equally so the head of a train- 
ing school will find it wise in the long 
run to keep the nursing schools out ot 
politics, and politics out of the school. 

In a number of schools in which one 
woman has been at the head for a con- 
siderable number of years, it has seemed 



to those in authority inadvisable to ap- 
point a graduate of the same school to 
the supervision and management when 
a vacancy occurred. The infusion of 
new ideas, and the introduction of new 
methods, so desirable in every school, 
can as a rule more easily be brought 
about by one who was trained in a 
different school, and no body of gradu- 
ate nurses should feel aggrieved or feel 
that a reflection had been cast upon them 
because a graduate of another school 
was chosen instead of one of themselves. 
If all hospitals were bound by rules or 
tradition not to allow any but gradu- 
ates of the school to hold responsible 
positions in the schools, conditions 
would become intolerable and the work 
would suffer serious embarrassment. 
This is especially applicable at the pres- 
ent time, when many superintendents are 
interested in furthering nursing enter- 
prises in which they have a financial in- 
terest. 

The attempt of graduate and pupil 
nurses to control the appointment of 
superintendent is hardly likely to be re- 
garded with favor by hospital authori- 
ties, and we seriously advise American 
nurses not to adopt the methods of that 
faction of the English nurses quoted in 
the clipping. 

There is much that is done in which 
the assigned motive is zeal for better 
nursing, and higher education, but in 
which the real motive is found in the 
determination of a few people to have 
their own way and have control when- 
ever possible. ^ 

For Social Betterment 

The American Journal of Surgery an- 
nounces that beginning with the June 
number it will establish a department of 
"Surgical Sociology," to consider various 
phases of the relations existing between 



EDITORIALLY SPEAKING 



97 



the needs of society and the responsibili- 
ties of the surgical profession. A full 
outline of what the department means to 
undertake is given in an editorial in the 
May number of the Journal. 

We would also call attention to the 
report of the proceedings of a meet- 
ing held in Boston, Mass., October 20, 
1909, under the auspices of the Com- 
mittee on Hygiene of Sex, Massachu- 
setts State Conference of Charities. This 
can be obtained from the Health Educa- 
tion League, No. 113 Devonshire street, 
Boston, Mass., on receipt of the price — 
8 cents. 



Our Critics 

In this month's Letter Box is a sec 
ond letter of criticism on the article *'A 
Tjrphoid Case in the Country," which we 
published in May. The writer of the 
criticised article also contributes an ex- 
planation in answer to the first criticism 
which applies to the second as well. 

We feel it to be only fair to us and to 
our contributors that a criticism written 
to appear on the pages of our magazine 
should show evidence that the artich 
criticised had been read comprchend- 
ingly. The criticisms of this article were 
in large part questionings, "Why was 
this done?" "What was that for?" etc. 
A careful reading of the article shows 
the answers to the questionings and re- 
futes the criticism. 

Criticism is of two kinds; that which 
finds fault, exposes and condemns it, an 
that which finds fault, exposes and cor- 
rects it. We welcome criticism ; we are 
always glad both to receive and publish 
it, but we feel that to be of value it 
should be of this second type, that the 
error be shown and a correction sug 
gested. In other words the critic should 



answer the question, "What would you 
have done?" 

We have always given a contributor 
the privilege of appearing in print over 
a nom de plume, initials, etc., providing 
the editor knew the name and address 
of the writer, but we believe that 
condemnatory criticism of an article, 
institution or person should appear over 
the author's signature. This seems to 
be the fair treatment of the one criticised 
and of the editor. 



Chemistry for Nurses 

In this number we take great pleas- 
ure in presenting to our readers the first 
of a series of papers on Chemistry for 
Nurses, by Miss Minnie Goodnow, Sup- 
erintendent of Bronson Hospital, Kala- 
mazoo, Mich. 

These lessons are the outgrowth of 
what the writer found to be a crying 
need in the teaching of nurses. All text- 
books and nearly all doctors assume that 
the nurses whom thev address have some 
knowledge of chemistry. In the aver • 
age training school about one nurse in 
ten has studied it, and the rest are hamp- 
ered by its lack. 

Chemistry forms an important part 
of the foundation of all other sciences, 
and a knowledge of it is neces- 
sary for the correct understanding 
of them. In the medical sciences the 
underlying principles of chemistry come 
into constant use. The study of physiol- 
ogy with its complicated processes of 
digestion and nutrition, of materia 
medica with its multiplicity of com- 
pounds, of urinalysis, and of dietetics, 
cannot be successfully undertaken unless 
the pupil has learned something of 
chemistry. 

These lessons are designed to give to 



98 



THE TRAINED NURSE AND HOSPITAL REVIEW 



nurses, not a chemical education, but 
only sufficient knowledge of the subject 
to enable them to comprehend their 
work in other lines. It is not intended 
for those who have studied chemistry, 
but for the very large number of nurses 
who have had no instruction in this 
branch. 

Theodore W. Richards, in an article 
ir the Atlantic, says: "Our bodies are 
wholly built up of chemical substances, 
and all the manifold functions of the liv- 
ing organism depend at least in part, 
upoa chemical reactions. Chemical 
processes enable us to digest our food, 
keep us warm, supply us with muscular 
energy. It is highly probable that even 
the impressions of our senses, and the 
thoughts of our brains, as well as the 
mode of conveying these through the 
nerves, are all concerned more or less 
intimately with chemical reactions. In 
short, the human body is a wonderfully 
intricate chemical machine, and its health 
and illness, its life and death, are essenti- 
ally connected with the co-ordination of 
a variety of complex chemical changes." 

+ 

A Voice from the Resrents' Office 

At the January meeting of the Medi- 
cal Society of the State of New York, 
held in Albany, considerable attention 
was paid to the question of nursing edu- 
cation and registration in New York. 
After a number of physicians had ex- 
pressed their dissatisfaction with the 
present situation in that State, Mr. A. 
S. Downing, of the Stale Education De- 
partment, Albany, spoke as follows : "It 
has been my official duty to study the 
question of training of nurses, and to 
deal with the problems involved. I am 
in sympathy with those who believe that 
we should provide by statute for a class 



of nurses, especially known as domestic 
or practical nurses, who shall go to the 
middle and poorer classes and give their 
services at moderate prices, but who, 
working under the immediate direction 
of the physician, are competent to per- 
form the ordinary duties required by 
the physician in the care of the sick. 
There are many people in moderate cir- 
cumstances who can afford to pay mod- 
erate prices for nursing, but who can- 
not afford to pay the extreme price of 
$25 or $30 a week for such services as 
are rendered by trained nurses. In the 
consideration of this question the medi- 
cal profession, the people at large and 
the registered nurses must all be pro- 
tected." 

On motion of Dr. Barber, of Roches- 
ter, a committee of five was appointed 
from the medical society to confer with 
a similar committee from the Board of 
Regents in regard to this matter. 



A Commendable Example 

The Illinois nurses have set a com- 
mendable example to nurses in general 
by their decision to erect a cottage for 
Illinois nurses who contract tuberculosis 
The cottage will be in connection with 
the Illinois Sanitarium. Every few 
weeks we hear of some nurse who has 
been obliged to give up her work owing 
to her having contracted this disease. 
Much time and money has been spent 
by nurses in journeying to California, 
Colorado, Texas, Arizona and such 
places in search of a cure. Now that 
it has been demonstrated that a cure is 
possible in practically any climate, given 
certain conditions, it is surely fitting that 
nurses themselves put forth an effort to 
provide suitable accommodations for the 
nurses of their own State who contract 



EDITORIALLY SPEAKING 



99 



the disease. Quite recently we were toKf 
by an architect that for the sum of $400 
upward an open air cottage, to accommo- 
date two nurses, could be erected. 
Usually the State or the tuberculosis as- 
sociation will provide the ground. No 
more worthy object has ever been under-' 
taken than this form of service, and we 
earnestly commend the subject to the 
consideration of State and local organi- 



zations. Illinois nurses are, of course, 
not the only ones to undertake this kinvl 
of work. Out on the Pacific Coast, the 
nurses of Washington State have taken 
a similar forward step and will build a 
cottage for nurses in connection with the 
tuberculosis camp to be established near 
Seattle. Let the good work go on. If 
others are working along this line, tell 
our readers about it. 



Virginia. 
Graduating exercises of the 1910 Class of 

the Memorial Hospital School for Nurses be- 
gan Sunday, May 22, when the Rev. S. C 
Hatcher, pastor of the Broad Street Methodist 
Church, delivered the Baccalaureate sermon. 

Monday, May 23, practical demonstrations 
were given by the class. The amphitheater 
was filled to its utmost capacity with friends 
of the graduates and with Richmond people, 
who have always maintained a keen interest 
in the work of the school. 

The commencement exercises proper took 
place Thursday, May 26, in the auditorium of 
the John .Marshall High School. There were 
ten graduates. The following day a dinner 
was given by Dr. Lewis C. Bosher, president 
of the hospital, at the Jefferson Hotel, to 
which the entire Alumnae Association was in- 
vited. 

The graduates are Miss Bertie M. Arritt, 
Miss Saddie Blankenship, Miss Pauline Brook, 
Miss Kate G. Gilliam, Miss Frances F. Hesser, 
Miss Minnie Howse, Miss Ida J. Lucas, Miss 
E. Meade, Miss Florence L. Reinach, Miss M. 
E. Taylor. The class motto: "Fidus et 
Audax." 

+ 
Married. 

Miss Mertie McDonald, former day super- 
visor of nurses at the Harrisburg (Pa.) Hos- 
pital, and Dr. Jesse L Lenker, a former resi- 
dent physician, were married March 31st, at 
about 9:30, at their newly furnished home. 
The ceremony was performed by Rev. Rene 
H. Williams, pastor of Messiah Lutheran 
Church. Onlv the immediate relatives and 



friends of both couples were present at the 
ceremony. 

Mr. and Mrs. Lenker will be at home to 
their friends at 21 North Fourth street. 



The marriage is announced of Dr. S. L 
Smith, of Poughkeepsie, N. Y., to Miss 
Mildred Gorham, who was a nurse in the 
Roosevelt Hospital in New York City. The 
marriage took place in Nova Scotia. The 
doctor is one of Poughkeepsie's physicians, 
having been practicing m that city about a 
year. Previous to that he was connected with 
Vassar Brothers' Hospital. 



Miss Alice Edith Bair, graduate of Colum- 
bia Hospital Training School for Nurses, 
Pittsburg, Pa., class November, 1909, was n-ar- 
ried in Wilkinsburg April 14, 1910, to Dr. J. 
Franklin Gonell, Marietta, Ohio. Dr. and 
Mrs. Gonell will live in Munhall, Pa. 



Miss Aha Briggs, a graduate of Green 
Gables Sanitarium Training School for 
Nurses, was married on June i, 1910, to Dr. 
Harry Brown. After an extensive Eastern 
trip Dr. and Mrs. Brown will be at home in 
Daykin, Nebraska. 



Miss Katherine Geesler, a graduate of the 
Amsterdam City Hospital, Amsterdam, New 
York, and formerly head nurse of the same 
hospital, and also a graduate of the Pennsyl- 
vania Orthopaedic Institute, was married on 
April 20, 1910, to Mr. George HoflF, of Frank- 
fort, N. Y. 



Ci)e l^osipttal B^eVitetD 



Hospital Noise. 

The annual meeting of the Canadian Hos- 
pital Association recently held in Montreal 
was one of unusual interest and value. Sev- 
eral speakers from the United States were 
present. Dr. Holmes, of Cincinnati, spoke on 
"The Hospital Unit," Dr. Earnhardt, of New 
York, on "The Nursing of the Insane," and 
Mr. Sturm, of Chicago, on "Hospital Con- 
struction." One of the most practical papers 
of the conference was given by Dr. Boyce, of 
the Kingston General Hospital, on the very 
prosaiic but intensely important subject to 
hospital people — "Noise." It is a thing com- 
plained of in practically every hospital, yet 
never remedied. In New York City one 
woman, Mrs. Rice, has for years been con- 
ducting a quiet campaign for the suppression 
of unnecessary noise. The inspiration for her 
campaign was an attack of illness, during 
which she had been tortured by noise, and she 
finally resolved that if she did regain her 
health in spite of the noise she would try to 
do something to suppress needless noise. 
Since her work began "zones of quiet" have 
been established around many of the hos- 
pitals. Civic authorities, factory managers, 
steamboat captains and numerous others in 
authority, who are in a position to check un* 
necessary -sounding of gongs, blowing of 
whistles and other disturbances, have been 
interviewed and co-operation secured, and in 
a quiet way much has been accomplished. 
"Zones of quiet" around hospitals are good, 
but "zones of quiet" inside hospitals are even 
more necessary. A league for the suppres- 
sion of noise in hospitals is badly needed. 
Who will start it? Speaking on the subject 
of noise. Dr. Boyce said that he thought if 
the whole number of hospital superintendents 
had suddenly to change places with the pa- 
tients and betake themselves to their cots how 
long would it be before there would be a 
revolution? Silence as a printed word may 
be prominent upon our door posts and lintels, 
but it enjoins a law honored more in the 



breach than in the observance. "Have you not 
heard," he says, "the slamming of the door, 
the doctor's stentorian 'Good Morning/ the 
stumbling of the visitor as he slowly mounts 
the stair, the laughing chatter of some idiotic 
house surgeon, or sillier nurse, the moaning 
of the operative, the crying of children, the 
whistling of the staff, and the thousand other 
noises which may be within our walls? But 
let us ask, do we really hear them, or have 
we become so accustomed to the commotion 
that it goes on all unnoticed. * * ♦ Judging 
from the little I could find written on this 
subject, I think it is one that is neglected 
both in theory and practice. * ♦ ♦ Can we not 
all see many ways in which this disturbing 
factor — ^'noise* — is preventing the realization 
of the highest efficiency of our hospitals?" 

Dr. Boyce stated that as conditions differed 
so greatly the problem had to be considered 
by each institution with its own difficulties 
in view, but he mentioned a few principles 
of general application: 

First — ^The site and its surroundings. This 
should be away from city traffic and not ad- 
jacent to factories. 

Second — The construction. Hospital archi- 
tecture had become a science and art by itself. 
The question of how to eliminate noise should 
be ever present during construction. 

Third — By the rearrangement of depart- 
ments, even in an old building, much could be 
done. Obstetrical and children's wards should 
be in a separate building; ward pantries so 
arranged that noise from them would not 
reach the patients. Bells should be replaced 
by electric signals. 

Fourth — ^The personnel of the staff was the 
most important of all. The superintendent 
should teach by precept and example that 
quietness was one thing needful for every one 
to observe. The interne with the swelled 
head, the jocular one who is always trying 
to provoke the nurses into spasms of laughter, 
and the one who insists on his right to make 
as much noise as he pleases, ought to be ban- 



THE HOSPITAL REVIEW 



101 



ished from hospitals. At least this was the 
inference. The physicians and surgeons are 
as noisy as any, but Dr. Boyce does not sug- 
gest what measures should be used to reduce 
these functionaries to order. 

Regarding nurses, he says : "Of all the in- 
dividuals connected with hospitals none can 
do more to disturb its peace or blast its pros- 
pects than the nurses. If after the weeding 
out done during the probationary period there 
are those who persist in disturbing the wards 
by engaging in foolish talking and laughing 
with house surgeons or visitors, they should 
be severely reprimanded. One who habitually 
distuH)8 her patients in this way does not care 
for their welfare; hence she will neglect them 
and doubtless make false records. She is 
not conscientious and faithful; hence, the 
sooner the hospital is rid of her the better 
for all concerned. We all know a great 
deal may be accomplished in keeping nurses 
in check by having a faithful, tactful head 
nurse in charge of the wards. Not only will 
she have a good effect in this connection, but 
every one in the ward will do her work in 
a quieter manner." 

In conclusion. Dr. Boyce asserts his belief 
that by eternal vigilance it is possible to 
change the atmosphere of our hospitals from 
that of ceaseless and bustling activity into one 
of calmness and repose. Wherern even the 
mo^t fastidious neurasthenic will not find 
noise a source of irritation and where weary 
sufferers may in very truth find real rest. 



American Hospital Asaoclation Convention. 

The twelfth annual conference of the 
American Hospital Association will be held 
in the convention hall of the Planters' Hotel, 
St. Louis. Among the papers to be presented 
are the following: 

1. "Relationship of Trustees to Superintend- 
ent." Dr. Henry M. Hurd, Johns Hop- 
kins Hospital, Baltimore, Md. 

2. "Private Rooms in General Hospitals." 
Dr. C. Irving Fisher, Presbyterian Hos- 
pital, New York City. 

3. "The Training of Hospital Superintend- 
ents and Heads of Departments.*' Dr. F. 
A. Washburn, superintendent Massa- 
chusetts General Hospital, Boston, Mass. 



4. "Co-operation vs. Individualism in the 
Care of the Sick." Mr. Bailey B. Burritt, 
secretary State Charities Aid Associatioti, 
New York City. 

5. "Preparation and Use of Detailed Re- 
ports for Smaller Hospitals." Mr. Walter 
Mucklow, director St. Luke's Hospital, 
Jacksonville, Fla. 

6. "The Education of the Nurse in America." 
Dr. Richard O. Beard, secretary Uni- 
versity of Minneapolis Hospital, Minne- 
apolis, Minn. 

7. "The Hospital as a Commercial Factor." 
Mr. Del T. Sutton, editor Internationa! 
Hospital Record, Detroit, Mich. 

8. "Methods of Raising Funds for a General 
Hospital." Miss Lucia L. Jaquith, super- 
intendent Memorial Hospital, Worcester, 
Mass. 

9. "Hospital Construction in St. Louis." Dr. 
Wayne Smith, superintendent University 
Hospital, St. Louis, Mo. 

Two special committees will report on sub- 
jects of unusual interest at this meeting. The 
Special Committee on "The Education ana 
Training of Nurse Assistants for the Care of 
People of Limited Means in their Homes and 
the Nursing of Patients Suffering from 
Chronic Diseases" will make a report which 
will be of interest to hospital workers and 
physicians in general. The report of the 
Special Committee on "Bureau of Hospital 
Information and permanent Secretaryship" 
will deal with the advisability of establishing 
a permanent headquarters or office for the 
association. 

+ 

A Couree in Hospital Administration. 

For some time past the authorities of the 
Methodist Episcopal Hospital, Brooklyn, N. 
Y., have been considering the establishment 
of a course in hospital administration similar 
to that now given at the Grace Hospital, De- 
troit, and the Massachusetts General Hospital, 
Boston. Those who are interested in the ex- 
tension of facilities for training in hospital 
management will be glad to learn that the 
course is to be launched this Fall. It will ex- 
tend over six months and will include instruc- 
tion in the management of the details in the 
business office, the office of the supervisor of 



102 



THE TRAINED NURSE AND HOSPITAL REVIEW 



nurses and of the various departments of the 
hospital. 

Recently enlarged, the hospital has now a 
bed capacity of about 250, and is exceptionally 
well equipped in all its departments. The 
following departments are maintained: Gen- 
eral medicine, general surgery, obstetrics*, 
children's diseases, orthopedics, throat and 
nose, eye and ear, electro-thermotherapy. 

In addition a limited number of post-grad- 
uate students will be admitted for special 
training in practical nursing. This course 
will be largely elective, so as to meet as com- 
pletely as possible the needs of the individual 
nurse and will also extend over six months. 
The privilege of gaining special experience 
in the operating room, the diet kitchen and 
in the care of private patients will be made 
possible for those desiring it. The obstetrical 
department is a large and growing feature of 
the hospital work. 

In adapting the general arrangement so as 
to provide for these changes, the term of 
the general nursing course for undergraduates 
has been changed from three years to two 
vears and six months. 



A Golden Jubilee. 
It is given to but few people to remain 
forty-one years as superintendent of a hos- 
pital. During the closing week of May a 
unique celebration took place at Mercy Hos- 
pital, Chicago, being the golden jubilee of 
Sister Mary Raphael, who has been fifty 
years a nun, and forty-one years superintend- 
ent of Mercy Hospital. Pope Pius sent a 
ca'blegram with his special blessing. Dr. John 
B. Murphy and others paid their tributes. 
The ampitheater was decorated with flags and 
flowers. After the banquet. Sister Mary 
Raphael was presented with a substantial 
purse, to be used for her personal needs and 
comfort. Dr. Murphy stated that she began 
her career as a hospital superintendent before 
the days of aseptic surgery — had seen many 
patients die of hospital gangrene, and had 
had to learn how to manage a hospital, then 
unlearn much, and learn it* again in accord- 
ance with modern science. Another speaker 
remarked that her life, like that of Jane 
Addams and Ella Flagg Young, was an argu- 
ment for women in high executive oflices. 



Victorian Order Hoepitala. 

The annual volume of the Victorian Order 
of Nurses numbers 156 pages, and is a splen- 
did record of work and progress, and self- 
denying activity carried on in many places 
under great difficulty. If there are any who 
doubt that we have nurses as ready to under- 
take pioneer work to-day as in years gone by, 
we would recommend a perusal of the year 
book of the Order. An important part of 
the work of this society is the establishing 
and fostering of hospitals in frontier town.-* 
and out-of-the-way places far from largo 
medical centers. Eighteen of such hospitals 
are now under the care of the society, and a 
number of others have grown so as to no 
longer need the guidance and assistance of 
the order that brought them into existence. 
These hospitals are located all the way from 
Harrington, Labrador, on the east coast, to 
Rock Bay, Vancouver, on the west. Each of 
these received a grant from the Lady Minto 
Cottage Hospital fund. Miss Mary Ard 
Mackenzie is the efficient superintendent of 
the work of the order, the headquarters being 
in Ottawa, Canada. 



Notes and Newt. 

The German Hospital, Brooklyn, N. Y., has 
completed its tenth year and already has far 
outgrown the present capacity of the building. 
During the year 1881 patients were admitted 
to the wards, and 587 accident patients were 
treated. The operating expenses for the year 
amounted to $63,025.94. A large new dispens- 
ary building was completed, a mattress steril- 
izer was installed, a refrigerating plant ar- 
ranged for and numerous other practical im- 
provements were made. There is urgent need 
for additional accommodation. Mr. William 
H. Condon is superintendent, and Miss Ella 
Kurtz, superintendent of nurses. 



A hospital, under the management of the 
Franciscan Sisters is to be erected in Water- 
loo, Iowa, this year. Mr. J. H. Temme, who 
superintends the erecticn of hospitals for the 
Franciscan Sisters, will arrive in Waterloo 
to take charge of the construction as soon 
as the hospital, now nearing completion in 
Milwaukee, is entirely finished. There will 
be 78 private rooms and the building will 
accommodate 100 patients. 



THE HOSPITAL REVIEW 



103 



By July 1st it is expected that the new ad- 
dition to Graham Hospital, Keokuk, will be 
completed. The hospital is conducted under 
the auspices of the Methodist Church. Many 
changes have also been made in the old build- 
ing. The old signal bell service has been done 
away with and a modern electric flash light 
service installed. The new building provides 
for X-ray rooms, a suite for patients tempor- 
arily insane, a splendid operating department, 
besides many private rooms, making it one 
of the best equipped of the smaller hospitals 
in the Mississippi valley. 



A tent hospital camp for tuberculosis pati- 
ents is to be established at Fort Wayne, Ind. 
The equipment is to be provided by the 
National Red Cross, from a fund created by 
the sale of Christmas stamps. 



The Indiana State Tuberculosis Hospital, 
near Rockville, is practically completed, but 
as the legislature appropriated no funds for 
maintenance, it may have to remain idle till 
the next session of the legislative body. 



An addition to the St. Barnabas Hospital, 
Minneapolis, to cost $54,000, has been begun. 

The contract has been let for a $37,000 ad- 
dition to the Presbyterian Hospital, Pitts- 
burg. 



The Baldwinville Cottage Hospital is to 
receive $15,000 by the will of Martha R. Hunt, 
of Somerville, Mass. 



Bethany Hospital, Kansas City, Mo., is to 
have a new building to cost $160,000. The 
hospital will be built in a five-acre park, will 
contain 153 rooms and will be, when com- 
pleted, one of the splendidly equipped hos- 
pitals in the Southwest. 



The Board of Education will supply a 
teacher to the Children's Free Hospital, 
Detroit 



Mrs. A. J. Cassatt, of Haverford, and her 
children have donated a building to the Bryn 
Mawr Hospital to be used as a children's 
ward. 



The New England Deaconess Hospital, Bos- 
ton, has completed its fourteenth year, during 
which 962 patients were treated. Three hos- 
pital needs are at present especially felt: 
There should be erected a new commodious 
nurses' home, an administration building and 
the wiping out of a debt of $37,000 on the 
present building. 

In the nursing department the hospital co- 
operates with the Cambridge Visiting Nurses' 
Association, two or three nurses being en- 
gaged in district nursing as a part of their 
training. Miss Adeliza A. Betts is the 
efficient superintendent, and Mr. Clarence A. 
Williams, the well-known specialist in hos- 
pital heating, ventilating, etc., is chairman of 
the Hospital Board. 



The Franklin Hospital, Franklin Falls, N. 
H., was formerly opened January ist. 



Ferris Hall, the new home for nurses and 
attendants at the State Hospital, Bingham- 
ton, N. Y., has been completed. It has accom- 
modations for about 150 persons. The cost 
was about $90,000. 



The new Jackson Hospital and Sanitarium 
at Jackson, Miss., has been formally opened. 



Dayton, Washington, has opened a hospital 
with accommodation for fifteen patients. 
Miss N. Grant, of Joplin, Mo., is to be in 
charge. 



Plans have been accepted for the new Grady 
Hospital at Atlanta, Ga., to accommodate 
about 100 patients. 



The new Coney Island Hospital has been 
ccn pleted at a cost of $350,000. It will ac- 
commodate no patients. A nurses' home, 
capable of accommodating 100 nurses, is a 
part of the new plant. 



A center building is to be erected at th.- 
Central Maine General Hospital, at Lewiston, 
to cost $75,000. 



St. Luke's Hospital, New York, is to re 
ceive a million dollar gift from the estate of 
the late D. O. Mills. 



Jh tl)e Ctamms Softool 



CONDUCTED BY CHASLOTTE A. AIKENS 



Demonstrative Teachins: 

CHARLOTTE M. PERRY 



Some little effort has been made to do 
away with the expression theoretical as com- 
pared with practical, with the idea that as 
all nursing knowledge is practical, the 
differentiation leads to confusion. Some 
would even go so far as to eliminate text- 
books. But for any craft requiring accurate 
knowledge we need both, and text-books are 
necessary for study and for reference. Pro- 
fessionally, our subject matter is very large. 
It is technical and difficult to the uninitiated, 
even to high school graduates whose home 
bringing up has not been what it should bt. 
So that although great stress is to be laid 
upon the practical element, the technical 
foundations are also important. When the 
subject matter for the guidance of Nurse 
Training schools was first issued there were 
two classes of objections. Some superin- 
tendents of training schools said — we have 
always taught all those details to our pupils. 
Some physicians considered that we were 
crowding and Obscuring the mind of the 
student by a mass of unnecessary and in- 
discriminating subects for study. However, 
as these methods work out on practical lines, 
as they are shown in their true colors, by re- 
arrangement and definite setting, it is ap- 
parent that the good accomplished by these 
progressive movements toward the better edu- 
cation (not the over-education) of the nurse 
are being appreciated. 

To make our teaching effective, we need 
certain conditions as well as the improved 
methods. The latter are valueless without 
the former. A sort of reaction brought to 
us for awhile the inferior candidate, as well 
as a falling off of applicants of the right 
kind. The forces which lay back of this 
condition are now coming to light. In the 
first place, the age itself is responsible for 
women, \Yho now have so many avenues 



opened to them, not selecting a vocation which 
requires courage and self-sacrifice; though 
many are realizing that nothing truly noble 
can be had without struggle, and also that 
the profession of nursing is richer in oppor- 
tunity than almost any other pursuit. In 
applying our methods with inferior pupils, 
and too few of them at that, we have met 
another serious obstacle. But there are hin- 
drances to all real advance, and now that 
enough progress has been made to bring 
cur difficulties clearly before us, we can set 
about to discover the remedy. The addition 
of lecture rooms to many training schools, 
the increase of the teaching staff as well 
as of the nursing staff, day classes, the 
refinite arrangement of the working sched- 
ule, with set time for study, and the sift- 
ing out of undesirable material have done a 
great deal toward success in carrying out the 
improved methods. 

In this success, demonstrative and pre- 
liminary teaching take first rank. It is time 
saved to the hospital, and to the patient, the 
avoifltince of discomjfort, loften of trying 
and fatal mistakes, to gather the probationers 
into preliminary classes, as is done at the 
MasFachusetts General Hospital in the most 
satisfactory manner. These new comers are 
taught not only the practical details of 
nursing, but personal and public hygiene and 
ethics, before taking up the work in which 
they are taught. It is absolutely necessary 
that the demonstrator be one who thoroughly 
understands the tradition of the hospital. In- 
novations work sad havoc with the pupil who 
is trying to do just as she is taught. If 
she returns to her ward to receive different 
instruction from her head nurse, the lessons 
are worse than lost; for careful habits, which 
are most necessary, are broken up before they 
really become established as habit. Sow an 



IN THE TRAINING SCHOOL 



105 



act and reap a habit. But the act must be 
the same seed, or there will be heterogeneous 
growth. This makes evident the wisdom of 
selecting the teachers carefully, of avoiding 
many changes of instructor. The traditions of 
any school are the most sacred of all its pos- 
sessions. Methods must tally with all the 
members of the teadiing staff, it it is to be 
said of the pupil "a stranger will they not 
follow." 

Public demonstrations before superin- 
tendents and members of other schools are 
of the utmost value. One is recalled at the 
Sim's Operating Theatre, New York, at the 



meeting of several schools throughout the 
country. New points were carried back and 
made part of their traditional stock. Too 
much emphasis cannot be laid upon the de- 
sirability of this exhibition of nursing technic 
in all the training schools — of taking new 
material and starting it right; of harmony 
among the teachers; of avoiding, as far as 
possible, changes in the teaching staff; and 
of providing suitable Jeoture rooms, with 
facilities for demonstrative teaching, where 
regular classes may be held, and the Hrst 
instructions clinched, before the prospective 
nurse starts out on her serious mission. 



Institutional Nursing 

CHARLOTTE A. AIKEN S 



The difficulty in securing capable institu- 
tional nurses is felt generally throughout the 
United States and Canada. Superficial ob- 
servers have attempted to account for this 
condition by saying: "Nurses do not want 
institutional positions. Private nursing pays 
so much better" — a half truth which will be 
accepted only by those who do not know better. 
The experience of several different individu- 
als who have attempted to conduct a bureau 
or agency for supplying nurses with institu- 
tional positions shows very plainly that there 
are plenty of nurses who want institutional 
positions. In fact, one after another of such 
ventures has been abandoned chiefly because 
of the overwhelming numbers of applicants 
for institutional positions in proportion to the 
demand. Wherein then lies the difficulty? 
Like most other difficulties, it has two sides — 
at least two sides that used to be considered — 
the institution side and the nurses' side. A 
nurse on being asked why she gave up her 
position as head nurse at a certain well-known 
hospital replied: "The work was too hard, 
the hours were too long, and the pay was too 
small." These very same objections have been 
made, and could be made, in connection with 
hundreds of other institutions. Added to this 
is the fact that the institution provides 
for no advanced course of study or instruc- 
tion for its head nurses that would widen 
iheir knowledge beyond the special depart- 
ment to which they are assigned. It is not 
unusual to see an advertisement for a head 



nurse, offering $30, $35 or $40 a month. On 
inquiry one will find that the superintendent 
(or the board) wants and hopes to get for 
that price a thoroughly trained nurse graduate 
with "executive ability" and various other 
desirable qualifications. They will not get 
and retain capable women at that price. Plenty 
of nurses will accept such a position as a tem- 
porary arrangement. They will gladly ac- 
cept it if attached thereto is a comprehensive 
practical course of instruction along some 
special line — ^part from bedside nursing. But 
it is difficult to convince the capable gradu- 
ate nurse with executive ability that an aver- 
age wage of $1.00 to $1.50 a day, or less, is 
a just equivalent for the skilled service de- 
manded of her. When a nurse is an unknown 
quantity, with her ability and desirability as a 
head nurse yet to be found out, it is not 
unreasonable to offer the salaries mentioned 
for a definite trial period — ^three months or 
four months, or six months, perhaps, but with 
it should come the assurance that if she 
"makes good" as a head nurse or night super- 
visor her salary will be increased, she can 
afford to work for these salaries till she gets 
some experience. A hundred or a hundred 
and fifty dollars a year added to the salary of 
half a dozen head nurses is a mere bagatelle 
in the total expense of an ordinjiry institution, 
say of a hundred beds. The cost of such an 
institution will run anywhere from perhaps 
$60,000 a year up to $100,000. One thousand 
dollars more expended, or even less than that, 



106 



THE TRAINED NURSE AND HOSPITAL REVIEW 



in many such institutions, and a few addi- 
tional comforts, would help very largely in 
solving the head nurse problem. The capable 
head nurse, who is assigned to one special de- 
partment, to attend to certain routine duties 
there day after day, or night after night, can 
be content to remain, if while performing 
those routine duties she is able to make a 
substantial saving for the future— otherwise 
she cannot, and should not. She can be con- 
tent to accept a small wage if she is getting 
a well-rounded, advanced training and ex- 
perience that will fit her for a position of 
greater responsibility in the future. 

Two or three large hospitals of which I 
have knowledge have worked out a plan which 
has very largely removed their difficulty of 
securing competent head nurses. They give 
a three year course of training. At the end 
of two years there are sure to be several 
nurses in each class who have demonstrated 
their fitness and desirability along the line of 
supervisory work. A certain number of these 
are selected and given the opportunity to take 
up such work as heads of department, if they 
will contract to remain with the hospital for 
two years longer on a definite salary. This 
makes for those nurses a four-year course — 
two of which are spent in general bedside 
work, and two in "executive work" as heads 
of departments. A general course on hospital 
and training school administration covering 
two years is given them. For the first year 
of this institutional course, which makes their 
third year of training, they receive, I think, 
either $25 a month, or $30, and for the second 
year an advance of $5 or $10 a month. If they 
elect to remain with the institution longer, of 
course they may with their experience and 
training, but most of .them readily find posi- 
tions as superintendents of hospitals or train- 
ing schools at a better salary than they could 
command as head nurses. 

Another phase of the head nurse question 
is the matter of accommodation. In a great 
many hospitals no special, no better accom- 
modations are provided for head nurses than 
for probationers. The hospital needs capable 
trained women in such positions permanently. 
It expects the head nurse to consider the 

(To be 



institution as her home and keep its interests 
always to the fore, yet in many places there 
is a strange lack of "home" comforts such 
as a refined woman needs, and as head nurses, 
who are constantly surrounded by depressing 
influences and perplexing human problems, 
ought to have. 

There is no lack of suitable material for 
institutional work, or, in othier words, of 
nurses — given a suitable training — who are 
suitable for hospital positions. 

There is rarely a graduating class in a school 
of moderate size which has not some nurses in 
whom the authorities see splendid possibilities 
of development along executive lines. What 
we lack are proper plans for developing 
those possibilities and the spirit which is 
willing to make it worth while for nurses 
with executive ability to develop, in a well- 
rounded manner, the powers they possess. 
The solution of the head nurse or institu- 
tional nurse problem rests in the hands of 
superintendents of hospitals and hospital 
schools. It demands attention and concerted 
action on the part of the moderate sized and 
large institutions. No one else will ever solve 
this problem for hospital people. It is their 
job, their responsihility. Others may try to 
work at it, or play with it, but they alone 
can work the problem out to a solution. 

It would be unfair to suggest that these 
criticisms apply to American hospitals as a 
whole, for one will find a diversity of con- 
ditions that makes it impossible to "lump" or 
group hospitals in any one class, or to make 
sweeping criticisms that apply to institutions 
in general. In many institutions, both small 
and large, the head nurses have good accom- 
modations and are fairly well paid. In others 
there is a more or less irregular procession of 
head nurses through the institution, and it 
is not unusual to find that where four gradu- 
ate head nurses are employed the whole four 
positions have changed heads in the course 
of a year or less. At the bottom of the 
problem will often be found the fact that the 
nurse wishes institutional work, prefers it to 
any other line of work, but cannot afford to 
spend the best earning years of her life for 
the money that is offered. 

continued.) 



iSook B^etitetDSf 



Medical Inspection of Schools. By Gulick 
and Ayres. This book first appeared in Octo- 
ber, 1908, and was reprinted in January, 1909, 
and in December, 1909. It is one of the by- 
products of the "Backward Children Investi- 
gation," a research supported by the Russell 
Sage Foundation, of which the authors of the 
book are directors. 

Medical inspection of schools has now become 
so firmly established, here and abroad, as an 
eflFective measure in protecting the community, 
as well as furnishing the physical conditions 
uirder which wholesome life can develop, that 
any argument for its adoption seems unneces- 
sary. It is alike curative and preventive. This 
is clearly set forth in this contribution by the 
Russell Sage Foundation. Twelve chapters 
deal with the various phases of school in- 
spection, viz. : Inspection for detection of con- 
tagious diseases, the teacher, the school nurse, 
physical examination, vision and hearing tests, 
administrative, controlling authorities, legal 
aspects of medical inspection, retardation and 
physical defects. Six sheets, sixty-four forms 
and thirty-one tables are interspersed in the 
text, and there are three indices containing 
"Suggestions to Teachers and School Physi- 
cians," "Typical Set of European Blanks and 
Forms" and "Rules Issued to Medical In- 
spectors of Shools.*' 

The development of medical inspection has 
demonstrated the need of school nurses, and 
in many parts of this country the growth is 
toward the great expansion of this branch 
of nursing. Dr. S. W. Newmayer, of Phila- 
delphia, terrns the school nurse "the most 
important adjunct to medical inspection," 
while in New York the Commissioner of 
Health says: "The school nurse has been 
voted a success from the day she began work." 
Dr. Thomas F. Harrington, of Boston, 
writes: "It does not seem possible to con- 
ceive a more satisfying arrangement or a 



more effective piece of school machinery than 
the school nurse under school supervision." 
Nurses are rapidly fulfilling the demands, and 
many training schools have opened courses 
of instruction on the duties of the school 
nurse. To quote the book before us: "To 
sum up the case for the school nurse — she is 
the teacher of the pupils, the parents, the 
teachers and the family in applied practical 
hygiene. Her work prevents loss of time on 
the part of the pupils and vastly reduces the 
number of exclusions for contagious diseases. 
She cures minor ailments in the school and 
furnishes eflFicient aid in emergencies. She 
gives practical demonstrations in the home of 
required treatments, often discovering there 
the source of the trouble, which, if undiscov- 
ered, would render useless the work of the 
medical inspector in the school. The school 
nurse is the most eflFicient possible link be- 
tween the school and the home. Her work is 
immensely important in its direct results and 
very far-reaching in its indirect influences. 
Among foreign populations she is a very 
potent force for Americanization." 

The results of medical inspection, as well 
as the methods for carrying out the work by 
both physicians and nurses, are all given 
clearly and graphically. There is no other 
book so well adapted to the needs of the 
nurse who is contemplating taking up this 
branch of public service. As a book of gen- 
eral information on many subjects not treated 
in the usual medical text-book, the nurse will 
find this volume most suggestive and helpful. 
As a means to preparation for work in schools, 
factories, social service and settlements, such 
a guide as this book oflFers is a necessity. The 
sources of information are the best and the 
book is prepared with a view of giving to 
physicians and nurses a concise, accurate view 
of this new branch of medicine and nursing. 
We commend the volume highly. 



Please note our prise offer. See advertisement in this issue. 



THE EDITOR IS NOT RESPONSIBLE FOR THE VIEWS OF OONTRIBUTORS 



\ 



A Criticldhn, 

To the Editor of The Trained Nurses- 
Several of the leading members of our 
profession here beg of you to enlighten us 
as to the report of a typhoid case in the 
country that appeared in the May issue of 
The Trained Nurse. 

Was it a bona fide case, and was the nurse 
a graduate nurse, and if so, of what kind of 
a school, and if she received any training 
was it not some decades ago? 

Why does she not study up on disinfection? 
And why so extravagant? Four granite bed 
pans, and six granite urinals for one patient, 
and the amount of sticky fly paper and mos 
quito netting! And how could she use six 
"fly spatters"? We have decided that thr 
$20.00 she received was ample remuneration 
for her services. We trust that the valuabl.^ 
and generally truly helpful pages of our 
Trained Nurse will not again bring to us such 
useless (and to the recent graduates of small 
schools harmful) matter. 

I was superintendent of a typhoid hospital 
in an Eastern city during an epidemic of 
typhoid. 

As Eastern Graduate in a Western Terri- 
tory. 

[Read Miss Nelsen's answer In this number. 
—Ed.] 

+ 
What Would You Have Done? 

To the Editor of The Trained Nurse: 

In the letter box of the June issue there 
appeared a criticism of my article on "A 
Typhoid Case in the Country." I am sending 
a reply or an explanation which, should you 
deem the subject worthy of so much space, 1 
would be glad to see appear in the Letter Box. 
The criticism affords me both amusement 
and chagrin; amusement that my critic wrote 
before she had read undcrstandingly the con- 
ditions I outlined and the methods I used; 
chagrin that I did not write so plainly that 
not only "he who runs," but she who skips, 
may read and comprehend. 
The article was not written as a "parody 



on nursing," nor was it intended to be in- 
structive in the sense of telling how to man- 
age typhoid in the country, but simply as a 
report of a case which I thought was so un- 
usual in its setting and accompanying condi- 
tions as to be of interest. It was a place 
where the ordinary routine of procedure did 
not flt at all. 

As I review the published account, I can 
see the possibility of it being understood 
that I knew no other way of disinfection. 
My critic asks how I could have missed learn- 
ing the "sane, easy methods of disinfection 
taught in the training schools." I think that 
without egotism I can state that my training 
and experience have been equal to the average, 
and it was my very knowledge of the possi- 
ble futility of the "sane and easy" way that 
led me to use a sure, if insane, method. Less 
than a year before I had known of a case oi 
typhoid where the routine chemical disinfec- 
tion was carried out conscientiously, but a 
spring, the source of the water supply, became 
contaminated, with seven cases, one the nurse, 
and two deaths resulting. Everybody was 
blamed until, after laboratory tests, the dis- 
infectant was proven nert. A few years a^o 
I was in a hospital where the routine of dis- 
infection for typhoid excreta was to mix 
with chloride of lime and let stand for a 
period before emptying in the hopper. An 
enterprising house doctor experimented with 
faeces so treated and grew healthy cultures. 
The method of disinfection was at once 
changed; the reason given was that the chlor- 
ide of lime coated the waste pipes. Needless 
to say the happening was not published broad- 
cast.* 

This knowledge, not my lack of knowledge, 
made me doubt means of disinfection the 
efficacy of which I must take on faith. 



* Perhaps had the writer included in the origi- 
nal article this paragraph of explanation of 
why she was reluctant to depend on chemical 
disinfection adverse criticism of the method 
employed would have been lessened thereby. 
Nevertheless, we feel she is quite justlfled In 
answering her critics with the question, "What 
would you have done?*' 



THE EDITOR'S LETTER BOX 



109 



Regarding other criticisms, I feel that a 
reasonably Claretful reader (will understand 
from my article why I needed every one of 
the things I gave in my list. Just for one 
instance this critic asks why "even in the 
home of a Rockefeller" would fifty yards 
of mosquito netting be needed. It wouldn't 
be needed there. I did need it, in a house 
where the only attempt at screening was slats 
tacked across the pantry window to keep 
cats out. I refer my critic to page 294 of 
the May issue, to the paragraph about the 
use of the netting. 

The criticism of my associates at the nurses' 
registry was of so different a character that 
it seems the written report made a very dif- 
ferent impression from a verbal one. The 
registry criticism was that I was unprofes- 
sional in staying on a case where the doctor's 
attitude was so discourteous; that I ought 
never to have recognized and carried out a 
doctor's direction given to a patient; that I 
should have reported the doctor to the Board 
of Health for his disregard of sanitation; 
that it was disgraceful to do the washing; 
that I should have brought suit to recover 
full pay for my work, etc. 

I believe that I carried out my profession's 
purport, conscientiously and in the most prac- 
tical way, all things considered. I would like 
to ask my critics just what method they 
would have employed to attain the same re- 
sults. It is very easy to say. "You ought tc 
have done," "You ought not to have done." 
Is it quite as easy to answer, "What would you 
have done?" I leave that question before you. 

Anna R. Nelsen. 
+ 
Seventh Day Adventiet Nurses. 

To the Editor of The Trained \Urse: 

The article in the July number by James 
D. Montgomery on Seventh Day Adventist 
nurses has been read and reread with very 
great interest, and I feel "moved" to reply. 
The first thing I would say is that though 
the writer evidently aimed to show that the 
S. D. A. nurses were of a different order 
from the regular everyday type graduated 
from other schools, he is unquestionably mis- 
taken in many particulars. They n*ay be "a 
peculiar people, zealous of good works," but 
hot quite so "peculiar," not quite so different 
from the rest of us, as he imagines. Hydro- 



therapy is taught and practiced in all good 
schools whether they are S. D. A. schools or 
not. I felt like saying as I read of some of 
the differences he claimed: "All these have 
I known and practiced from my youth up." 
It looks to me as if the gentleman were trying 
to attribute the changes in medical teaching 
and practice for the last ten years to the 
Seventh Day Adventists. For instance, 
"Morphia and other drugs are considered 
good nerve sedatives, but our people anly re- 
sort to them in extreme emergency. For a 
nerve sedative it has been found that hot appli- 
cations to the spine and massage give ex- 
cellent results." Where is there a training 
school where those very points are not taught 
and practiced? 

Another illustration: '^Calomel," he says, 
"is considered by the profession at large as 
an efficient cholagogue, but our nurses regard 
the hot and cold alternate applications to the 
area over the liver as more efficient than the 
chloride and much less dangerous. They 
also recognize the specific action of certain 
fruits and use them as occasion may indicate." 
If a doctor orders a dose of calgmel for a 
patient, will S. D. A. nurses refuse to give it, 
and prescribe instead the hot and cold applica- 
tions over the liver? What difference what 
treatment nurses regard "as more efficient;" 
have they any right to prescribe them or sub- 
stitute them for the one the physician orders? 
From the beginning of nursing nurses hav^ 
had to give treatments under a physician's 
order which they, perhaps, did not approve 
of. It was not their business to approve or 
disapprove of them, and the bare sugges- 
tion of nurses following the example of the 
S. D. A.'s, as described in the article, would 
create a revolution in the medical and nursing 
world in a short time. ' 

Further the writer says: "In the medical 
creed of this people is an article stating 
that poisonous drugs are not necessary in the 
treatment of diseases." * * * The saline lax- 
atives and other drugs are used to induce 
movement of the bowels, but these nur§es have 
learned to value the enema as more desirable 
in many ways. Also they are trained to diet 
for the same results. ♦ * * Acetanilid may be 
a specific headache remedy, but we find that 
headache may usually be relieved without 
resort to this remedy. I wish to ask if the 



no 



THE TRAINED NURSE AND HOSPITAL REVIEW 



S. D. A. nurses always nurse for S. D. A. 
doctors, and if they do not, how far do they 
go in carrying out the medical creed that 
poisonous drugs are unnecessary in the treat- 
ment of diseases? Also I would like to sug- 
gest to the writer that in more than one text- 
book prepared for nurses and in use in the 
best schools he will find lists of fruits and 
foods having a laxative effect, and the dan- 
gers of acetanilid as a headache remedy are 
commonly taught to probationers and to the 
public at large. I have no quarrel with much 
of the doctrine the writer wishes to spread, 
but I object to the suggestion that many of 
the methods and beliefs mentioned are pecu- 
liar to the S. D. A. nurses. 

If the author of the article believes that 
in the use of remedies the company of nurses 
under consideration work on entirely different 
lines from those of most other schools, he is 
wrong. It is true they may put mere emphasis 
on some of these points in S. D. A. schools, 
but it is largely a question of emphasis, not 
of discovery, if the methods mentioned are 
typical of the training in S. D. A. schools. 

Anna W. Baiiclav. 
+ 
An Experience in China. 

To the Editor of the Trained Nurse: 

When the United States soldiers were on 
duty at Tientsin, China, during the Boxer 
trouble, the splendid American missionary 
homes and schools were vacated and used as 
hospital wards for our sick, wounded and 
exhausted soldiers during the great ninety- 
mile march to Pekin. 

The bombardment of the Chinese forts at 
Taku Hartor disturbed the Gulf so that the 
water looked like mud for many miles out 
Irom shore. 

From distances of more than thirty miles 
down the Peiho River the bodies of dead 
Chinese were floating out into the sea. The 
stench arising from the burning ruins of vil- 
lages full of dead bodies made life almost 
unbearable; and through it all we slowly 
traveled toward Tientsin to the General Hos- 
pital. There, on Taku Road, the British sol- 
diers put up an apparatus to boil and filter 
the drinking water, then selling it to the sol- 
diers. In the United States Hospital small 
hand-filters were used. After the water had 
been boiled and filtered, it was placed in large 



granite buckets. These buckets were then 
surrounded by lake ice to cool the water be- 
fore drinking. This lake ice was found in 
large cellars in China and was impure, there- 
fore could not be put into the water. From 
various cities the United States soldiers came 
to this General Hospital to be cared for as 
they dropped out of line of duty, by shell or 
shot or from exhaustion. The patients were 
put on flat river beats and the Chinese coolies 
dragged these boats down the river. At one 
tiire we averaged more than two hundred 
patients a day (exhausted). 

One day an unconscious patient was carried 
into my ward in a very feeble condition, with 
a temperature (by axilla) of io6 degrees, and 
the pulse 140 beats per minute; face very red, 
breathing very rapidly, bad breath. He was 
promptly placed in a cool pack, ice cap to 
head and abdomen, and his pulse was toned 
up with heart stimulants, as per surgeon's 
order. 

The patient had been taken suddenly ill 
while marching, and fell into a stupor, with 
symptoms of exhaustion from the August 
heat 

For six hours of faithful work we could 
see no sign of improvement, when suddenly 
the patient gave signs of retching, nausea, 
and then vomited. 

In the vomitus were found worms, about 
nine, all in a mass, as if tied or knotted 
together in the middle, some nine inches long, 
some shorter, commonly called "pin worms," 
often found in impure drinking water, caus- 
ing symptoms of gastrointestinal irritation. 
After vomiting, the patient sat up, looked 
around, and said : "I am hungry.*' 

When the temperature and pulse were 
taken, both were normal. 

The patient was somewhat exhausted, 
otherwise in good condition. He was placed 
upon a liquid diet for that day. 

The next day, early, he was given the San- 
tonin and Calomel treatment, with good re- 
sults. For several days after these parasites 
were found in the defecations. In a few 
more days the patient was well and reported 
for duty. After this experience, while on 
duty in the East, especially in the Philippine 
Islands, we often cared for patients suffering 
from worms. 

Ida D. Lippert. 



Jin tje purging Wnxln 

ASTICLES IN THIS DEPARTMENT, WHETHER BEARING SIGNATURE OR NOT, ARE GONTRIBUTED, ANB 
DO NOT NECESSARILY REPRESENT THE IDEAS OR POLICY OF THIS MAGAZINE 



1 



Maryland. 

Graduating exercises of the Training 
School for Nurses of the Hebrew Hospital, 
Baltimore, Md., were held in the vestry rooms 
of Madison Avenue Temple. 

Six young women received their diplomas. 
They were: Misses Xancy Alderson Hard- 
ing, of Virginia; Mary Victor Hinder, Rena 
McCaig, Lillian Emma Raither, Sadie Carolyn 
Stewart, of Maryland, and Anna Louise 
Ligorie, of Connecticut. 

The exercises were opened with prayer by 
Rev. Dr. William Rosenau, followed by an 
address on "The Training School" by Dr. Jose 
L. Hirsh, who spoke of the great decreases 
in the mortality of the country since the 
institution of schools where young women 
are taught to care for the sick. Especially 
is this true, he said, in the battle with the 
white plague. 

The graduates received their diplomas from 
Dr. Harry Adler. The address to the gradu- 
ates was delivered by Dr. L. Ernest Ncale, of 
the University of Maryland. 

Vocal and instrumental selections were ren- 
dered. Miss Martha W. Row sang, and Miss 
Fredericka Perlman played the violin. They 
were accompanied on the piano by Miss Sadie 
Pearlman. The graduates, with the speakers, 
were seated on the platform, which was deco- 
rated with palms, ferns and orchids. Each 
nurse carried a large bouquet of daisies tied 
with the class colors, and wore a white uni- 
form. At night a reception was held at Leh- 
man's Hall, followed by a dance to the grad- 
uating class. 

+ 
Pennsylvania. 

The Seventh Annual Commencement of the 
Mercy Hospital Training School for Nurses, 
Wilkes-Barre, Pa., was held Tuesday evening. 
May 24th, in St. Mary's High School Audi- 
torium. The speaker of the evening was Hon. 
George S. Ferris. The prizes were awarded 
by Dr. F. P. Lenahan, and the diplomas were 



conferred by Mr. E. W. Mulligan. Miss Flor- 
ence McHale, president of the Nurses* 
Alumnae, presented the class pin. Musical 
selections, both vocal and instrumental, added 
to the enjoyment of the evening. The follow- 
ing comprised the graduating class: Mary 
Celestine Shields, Margaret Isadore Gill, Ellen 
Marie Higgins, Anna Pearl Smith, Mildred 
Elizabeth Bakaitis, Catharine Celestine McDer- 
mott, Catharine Hilda McAvoy, Rose Marie 
Ruff, Mary Florence Desmond, Adeline Mer- 
cedes Bonomo, Anna Frances Finn, Anna 
Agnes Kierns, Marie Catharine Boyle, Ber- 
nardine Marie Williams and Hannah Loretto 
McTague. 

The class motto is, "Wisdom, Charity, 
Prudence." 



The graduating exercises of the St. 
Agnes's Hospital Training School for Nurses 
were held in the Study Hall of the institution 
May 12, 1910. There were six nurses who re- 
ceived their diplomas. Dr. B. F. Stahl con- 
ferred the diplomas and Sister M. Borromeo, 
Superioress of the hospital, presented the 
f.iedals. Drs. Leon Brinkmann and D. J. Mc- 
Carthy delivered addresses to the class. 

The graduates are: Sister M. Augustine, 
Louise E. Scheid, Anna M. Sullivan, Pearl 
L. D. Helben, Emma C. B runner, Petronella 
M. Fanning. 



The graduating exercises of Wilkes-Barre 
City Hospital Training School for Nurses 
were held at the Y. M. C. A. Auditorium 
May 27, at 8 o'clock. The class, which num- 
bered eighteen members, and which was the 
largest in the history of the hospital, was com- 
posed as follows: Misses Olive E. Caste, 
Irene M. Carle, Gertrude L. Kistler, Anna 
Thomas, Mary L. Thomas, Mary Carrigan, 
Anna R. Evans, Isabelle G. Cairns, Edna R. 
Custer, Myrtle E. Gruver, Hilda G. Mann, 
Helen M. Search, Elizabeth M. Williams, 
Laura W. Dersheimer, Ethel E. Driesbach, 



GRADUATING CLASS, I9IO, MERCY HOSPITAL, WILKBS-BARRB, PA. 



114 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Mary Keating, Mary E. Manhart, Martha 
Siley. 

A reception at the Nurses* Home followed 
the exercises. 



The Pennsylvania State Board of Examin- 
ers for the Registration of Nurses has granted 
registration to 345 additional nurses. The 
list, as below appended, illustrates the very 
general interest which is taken in this move- 
ment. 

The list shows the following: 

Allen town, 5; Danville, 5; Erie, 12; Har- 
risburg, 8; Johnstown, 8; Meadeville, 7; Phila- 
delphia, 120; Pittsburg, 39; Scranton, 15; 
Uniontown, 5; Wilkinsburg, 8; Wilkes-Barre, 
9; outside of Pennsylvania, 22. 

+ 

Spanish-American War Nurses. 
The Eleventh Annual Convention of the 
Spanish-American War Nurses will be held 
at Atlantic City, N. J., September 20, 21, 22, 
19TO, with headquarters. Hotel Chalfonte. 
The following program and announcements 
have been sent to members: 

Tuesday, September 20. 
8 P. M. — Hotel Chalfonte Assembly Room. 
— Signing the Roster; the President's Ad- 
dress; Minutes of Last Meeting; Informal 
Reception. 

Wednesday, September 21. 
Morning — Sight Seeing ; Atlantic City Beau- 
tiful. 3 P. M. — Business Meeting. 

Thursday, September 22. 

10 A. M. — New Business. 3 P. M. — Elec- 
tion of Officers; Selection of Next Place of 
Meeting. 

The dates, September 20, 21, 22, have been 
chosen to enable ths Spanish-American War 
Nurses members to take advantage of the re- 
duced railway rates to the G. A. R. Encamp- 
ment, which is to be held in Atlantic City 
at this time. Consult your local ticket agents 
for details regarding stop-over privileges. 

Hotel rates are as follows: Chalfonte, Amer- 
ican plan, one room, one person, $3.50 to 
$4.00 per day; one room, two persons, $6 to 
$8 per day. Assembly room free. 

Phillips House, American plan, near Chal- 
fonte, $2.50 and up per day. 

New Clarion, American plan, six squares 
south of Chalfonte, $2.00 and up per day. 

The above hotels will not be overcrowded, 



but early reservations should be made through 
the Recording Secretary, Mrs. Harry Epps, 
Benning, D. C. 

All will be heartily welcomed to this beau- 
tiful city by the sea, where we hope to have 
a large and interesting meeting. 

Mrs. Geo. Lounsbery, R. N., 
Mrs. Harry Epps, President. 

Recording Secretary. 

Kindly report changes of address promptly 
to the Corresponding Secretary, Miss M. I. 
Ilarroun, 171 1 Cherry street, Toledo, Ohio. 

+ 
Massac hiisette. 

AN ACT 

TO PROVIDE FOR THE REGISTRATION OF NURSES. 

Be it enacted by the Senate and House of 
Representatives in General Court assembled, 
and by the authority of the same as follows : 

Section I. Within sixty days after the pas- 
sage of this act, the Governor, with the ad- 
vice and consent of the Council, shall appoint 
a Board of Registration in Nursing, to be 
constituted as follows: three members of said 
board shall be nurses holding diplomas from 
different training-schools for nurses, giving 
at least a two years' course in the theory and 
practice of nursing in a hospital, and who 
shall have had eight years* experience in 
. nursing the sick ; one member shall be a phy- 
sician who is a superintendent of a hospital 
having a training-school for nurses, and the 
remaining member shall be the Secretary of 
the State Board of Registration in Medicine. 
Said board shall be appointed as follows : one 
member for one year, one for two years, one 
for three years, one for four years, and one 
for five years, from the first day of October, 
nineteen hundred and ten, and until their re- 
spective successors are appointed; and there- 
after the Governor, with the advice and con- 
sent of the Council, shall, before the first day 
of October of each year, appoint in the man- 
ner aforesaid one person qualified as afore- 
said to hold office for five years from the 
first day of October next ensuing. Vacancies 
in said board shall be filled in accordance 
with the provisions of this act for the ap- 
pointment of the original board, and a person 
appointed to fill a vacancy shall hold office 
during the unexpired term of the member 
whose place he or she fills. Any member of 
said board may be removed from office for 



IN THE NURSING WORLD 



115 



cause by the Governor, with the advice and 
consent of the Council. 

Section II. The members of said board 
shall meet at the office of the State Board of 
Registration in Medicine on the second Tues- 
day of October, nineteen hundred and ten, 
and annually thereafter, and shall immediately 
proceed to organize by electing a chairman, 
who shall hold oflFice for the term of one 
year. The Secretary of the State Board of 
Registration in Medicine shall be Secretary 
of the Board of Registration in Nursing, and 
shall receive as compensation therefor such 
sums as may be determined by the Governor 
and Council, to be paid from fees received 
hereunder. The said board shall hold four 
regular meetings in each year: one on the 
second Tuesday of January, one on the sec- 
ond Tuesday of April, one on the second 
Tuesday of July, and one on the second Tues- 
day of October, at the office of the State 
Board of Registration in Medicine, and addi- 
tional meetings at such times and places as it 
may determine. 

Section III. It shall be the duty of said 
board, immediately upon its organization, to 
notify all persons engaged in the practice of 
nursing the sick in this Commonwealth of the 
times, places and subjects of the examinations 
for registration, by publication in one or more 
newspapers in each county. Application for 
registration shall be made upon blanks to be 
furnished by the board, and shall be signed 
and sworn to by the applicants. Each appli- 
cant for registration who shall furnish satis- 
factory proof that he or she is at least 
twenty-one years of age, and of good moral 
character, shall, upon payment of a fee of 
five dollars, be examined by the said beard; 
and upon such examination, if the applicant 
shall be found qualified, he or she shall be 
registered, with a right to use the title Reg- 
istered Nurse, and shall receive a certificate 
thereof from the board signed by the Chair- 
man and Secretary. An applicant who fails 
to pass an examination satisfactory to the 
board, and is therefore refused registration, 
shall be entitled, within one year after such 
refusal, to a re-examination at a meeting of 
the board called for the examination of ap- 
plicants, without the payment of an additional 
fee. Said board, after hearing, may, by vote 
of a majority of its members, revoke any cer- 
tificate issued by it, and cancel the registra- 



tion of any nurse who has been guilty of any 
felony or of any crime or misdemeanor in 
practice of his or her profession. All fees 
received by the board shall once in each 
month be paid by its Secretary into the treas- 
ury of the Commonwealth. 

Section IV. Examinations shall be in part 
in writing in the English language and in part 
in practical work, and shall include the prin- 
ciples and methods of nursing. Due credit 
shall be given for examinations in special 
branches. 

Section V- Any resident of this Common- 
wealth who shall make application for regis- 
tration within one year from the passage of 
this act, and who shall show to the satisfac- 
tion of the board, by affidavit or otherwise, 
that he or she has actually engaged for five 
years next prior to the date of application in 
nursing the sick in a competent manner, or to 
have had such experience in hospital or train- 
ing-school as in the opinion of the board to 
justify registration, shall be registered with- 
out examination on the payment of a fee of 
five dollars. 

Section VI. The board shall have power to 
register in like manner, without examination, 
any person who has been registered as a pro 
fessional nurse in another State under laws 
which in the opinion of the board maintain a 
standard substantially similar to that of this 
act. 

Section VII. Each member of the board, 
except the Scretary, shall receive five dollars 
for every day actually spent in the perform- 
ance of his or her duties, and the necessary 
travelling expenses actually expended in at- 
tending the meetings of the board, not exceed- 
ing three cents a mile each way. Such com- 
pensation and the incidental and travelling 
expenses shall ibe approved by the board and 
paid by the Commonwealth only from the fees 
paid over by the board. 

Section VIII. The board shall investigate 
all complaints of the violations of the pro- 
visions of this act, and report the same to the 
proper prosecuting officers. 

Section IX. The board shall keep a record 
of the names of all persons registered here- 
under, and of all money received and dis- 
bursed by it, and a duplicate thereof shall be 
open to inspection in the office of the Secre- 
tary of the Commonwealth. Said board shall 
annually, on or before the first day of Janu- 






116 



THE TRAINED NURSE AND HOSPITAL REVIEW 



ary, make a report to the Governor of the 
condition of professional nursing in this 
Commonwealth, of all its official acts during 
the preceding year, and of its receipts and dis- 
bursements. 

Section X. Whoever, not being lawfully au- 
thorized to practise as a registered nurse with- 
in this Commonwealth, does practise or does at- 
tempt to practise as a registered nurse, or does 
use the abbreviation R.N., or any other words, 
letters, or figures to indicate that the person 
using the same is such a registered nurse, 
shall for each offense be punished by a fine 
of not more than one hundred dollars. Who- 
ever becomes registered, or attempts to be- 
come registered, or whoever practises or at- 
tempts to practise, as a registered nurse under 
a false or assumed name, shall for each of- 
fense be punished by a fine of not less than 
one hundred nor more than five hundred dol- 
lars, or by imprisonment for three months, or 
by both such fine and imprisonment. 

Section XI. The provisions of this act 
shall not be held to apply to gratuitous nurs- 
ing of the sick by friends, or members of the 
family, or to the acts of any person nursing 
the sick for hire who does not assume to be 
a registered nurse. 

Section XII. The board may make such 
rules and regulations with reference to pro- 
cedure hereunder as they may deem wise; 
not, however, inconsistent with the terms 
hereof, or the laws of the Commonwealth. 

Section XIII. For the purpose of the ap- 
pointment of said board and of the registrar 
tion of persons by it hereunder, this act shall 
take effect upon its passage, and shall take 
full effect on the first day of October in the 
year nineteen hundred and ten. 



Exercises in celebration of the twenty-fifth 
anniversary of the founding of the Wajtham 
Training School for Nurses were held in 
Waltham on May 25, 1910. During the fore- 
noon the School, the Waltham Hospital, and 
the Baby Hospital were thrown open to vis- 
itors, and there were many who took advan- 
tage of the opportunity. At noon lunch was 
served at the School, shortly after which Dr. 
Worcester addressed the graduates at a spe- 
cial meeting called at the Cutler House. At 
three the more formal exercises were held in 
the church across Main street from the 
School, after which tea was served in the 



vestry, the plans for havii^ tea upon the 
lawn being given up on account of the du- 
bious character of the weather. In the even- 
ing a large reception was held in Maynard 
Hall, followed by dancing from nine until 
twelve. Notices of the celebration had been 
sent to all graduates, and as many as pos- 
sible attended, some coming from considerable 
distances. All agreed that it was most en- 
joyable and inspiring. 

At the afternoon exercises Dr. Worcester 
first gave a short reminiscent talk, telling how 
an illness of their first student nurse led to 
the choice of their first superintendent, her 
sister. Miss Hackett; speaking of the praise 
accorded Waltham nurses by Dr. Cowles as 
early as 1890, of his visit to Florence Night- 
ingale' five years later, when she advised the 
sending of nurses into families; of the choice 
of Miss Macleod to start the Victorian Order 
of Nurses in Canada on account of the train- 
ing in district work then given practically only 
in Waltham; of the new school building, and 
of the Putnam Home. He then introduced 
President Lefavour, of Simmons College, who 
gave his hearty congratulations, and, after a 
short talk on the economic position of woman 
and the importance of nursing, paid a warm 
tribute to Dr. Worcester. Miss Hackett, now 
Deaconess Hackett, spoke a few words of the 
early days of the school and the problems 
then encountered, of the helpfulness of Miss 
Adams and the other lady trustees, and paid 
a high tribute to Dr. Worcester. Miss Mac- 
leod, the second superintendent, also spoke 
briefly of the institution, of the preliminary 
course and of the tea given in the old school 
building to the people of Waltham that led to 
the recognition of the need of a new building 
and to the filling of the need. 

President Briggs, of Radcliffe College, gave 
a splendid address. He began by saying: 
"Some things commonly done by men, women 
are telling us that they can do as well, but I 
have yet to meet the woman who maintains 
that men can do well the things commonly 
done by women." Later he said: "Granted 
that most nurses must be women, what 
kind of women shall they be? The best in 
the world. Those who love greatly. No 
woman is too good for a life that saves lives 
and comforts living and wipes away all tears 
from the eyes." And again: "They say it 
takes a lady to trim lamps. It takes a lady to 



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118 



THE TRAINED NURSE AND HOSPITAL REVIEW 



see in sickening details the path to that ideal 
which elevates drudgery, that inspiration like 
His who washed the disciples' feet." 

Finally Dr. Palmer, of South Framingham, 
spoke on the inspiration derived by his school 
from Waltham, giving high praise to the Walt- 
ham methods of training and foretelling that 
Dr. Worcester would go down in history as 
the father of the new method of training. 

In closing. Dr. Worcester expressed re- 
gret that Dr. McCormack, at whose house the 
scheme of starting a training school was first 
proposed, was unable to be present on ac- 
count of the very serious illness of his eldest 
son. He also spoke a few words in acknowl- 
edgment of Miss Ann D. Adams's great ser- 
vices to the school, and ended with a brief 
tribute to Mrs. Worcester. 



At Quincy, in the Women's Club House, 
there was held, on June 15, a council of wom- 
an's clubs who w^ere enploying district nurses. 

Dr. Middleton gave a short paper on the 
value of the nurse there, and needed additions 
to the work, as seen by the physician. Mrs. 
Fisher, of Norwood, where the work is quite 
successful, gave an interesting talk, also two 
others of her club. 

Miss Robinson, the district nurse of Quincy, 
spoke pleasingly. 

Mrs. Williams, chairman of the Health De- 
partment of General Federation of Woman's 
Clubs, gave an account of the tuberculosis 
work of the State. 

Miss Prue, Birthelmstone Club nurse, of 
Brighton, Mass., gave an account of work 
there. 

Nine towns were represented in the gen- 
eral discussion following. Refreshments were 
served. 



The Governor of Massachusetts has ap- 
pointed the following persons to act on the 
new Board of Registration of Nurses: Mary 
M. Riddle, of Newton, four-year-term; Lucia 
Jaquith, of Worcester, three-year-term; Mary 
E. Shields, of Boston, two-year term; George 
T. Tuttle, M. D., of Boston, one-year term, 
and Edwin B. Harvey, secretary of the Board 
of Registration in Medicine. 



hope in time of abolishing the custom of em- 
ploying orderlies. It is interesting to know 
that after a trial period extending over many 
months the training school committee recom- 
mends continuing the work of training male 
nurses — this not from any idea of economy, 
because the monthly rate of payment to male 
nurses is about equal to that paid to orderlies 
— ^but because more efficient care to the sick 
is thereby secured. Inasmuch as the field for 
men nurses after graduation is much narrower 
than for women nurses, and the experience 
also that can be provided them more lim- 
ited, a two-year course has been arranged. A 
graduate male nurse is to be employed to in- 
struct the men pupil nurses along certain 
clinical lines, while the greater part of the 
foundation work for the first year will be 
taken in regular classes. The solution of the 
perplexing orderly question lies in education, 
and there is no question about the wisdom of 
the decision arrived at in the case cited. The 
difficulty which has led some hospitals to 
abandon the attempt has been that of secur- 
ing enough suitable men to train, but this 
difficulty can be overcome by paying a more 
attractive monthly allowance and by giving 
greater publicity to the facilities for training 
men that the hospital offers. It is true that 
a large number of the men who have been 
trained as nurses have not practised nursing 
many years. Man> of them have become phy- 
sicians, and they are surely the Letter phy- 
sicians for their practical experience and train- 
ing as nurses. In any case, the sick in the 
hospital have received better care at their 
hands than without them, the public has been 
benefited, and the young man is surely the 
better for the trair.ing and experience he has 
received. 



For some time, the City Hospital at Worces- 
ter, Mass., has been experimenting with the 
question of educating male nurses, with the 



REPORT CONTINUED.* 

Dr. Patch: Mr. Chairman, this question, 
like most of the others, seems to be one that 
is rather too big to be answered off hand. 
In the first place, the beginning of the ques- 
tion rather puzzled me. Is the domestic 
nurse a necessity? What is the domestic 
nurse? Is she a domestic or a nurse? I 
don't know what the asker of the question 
had in mind, but I suppose he meant some sort 

^Continuation of the report of tlhe tenth 
semi -annual meeting of the New England 
Association for the Education of Nurses, the 
subject under dUcusslon being the training 
echool niport of the Hospital Asaodetlon. 



ADVERTISEMENTS 



120 



THE TRAINED NURSE AND HOSPITAL REVIEW 



of an attendant. Of course we all understand 
that there is a great need for attendants, for 
nurse helpers of some sort, who can be had 
by poor families, or families in moderate cir- 
cumstances, and who can do some sort of 
efficient service. I don't feel at all sure yet 
how that demand is going to be met. I do 
think that in a large measure the nursing side 
of the demand might be met by further ex- 
tension of undergraduate service. ' I have 
always felt that to be a great field as yet 
practically untouched, the sending out of 
nurses during the last year of their school 
work at prices that people in moderate circum- 
stances could afford to pay. The quality of 
the service would be far in advance of any 
ordinary untrained service that can be had 
at present, or that we can expect to get. On 
the other hand, it would go a long distance 
toward filling some of the needs that Dr. 
Worcester has spoken of, that is, in giving 
the pupil an opportunity to go into the homes 
of people and learn more fully, than they 
usually can in any other way what social 
service is. This is a very real experience 
which nurses should have. Nurses who have 
had this element in training are always better 
equipped than those who are trained solely 
in the wards of great hospitals. But when we 
come to think of the training of attendants, 
there are some very serious questions, that is, 
if we are to speak of the training of attend- 
ants in separate schools; it brings up a whole 
new set of questions as to just what the 
training shall be, what salary they shall be 
expected to get and so on. 

Then again, how can such a nurse be kept 
in the sphere in which she belongs? She can- 
not be; it is utterly impossible. Any nurse 
who goes out with the understanding that she 
is going to have $7 a week will, in the course 
of time, demand more than that; it won't be 
more than a year or two before she is getting 
$10, $12 or $15 a week. And yet she has had 
practically no training as a nurse. I question 
if the plan of training attendants can be made 
a success largely for these reasons. At present 
we have a number of registries that send out 
attendants, but the service is most unsatisfac- 
tory; the majority of those nurses have failed, 
for one reason or another, in training schools. 
They have gone into the schools, taken a few 
months, and been turned down; they then go 
into the registries and register as untrained 



nurses, and receive anywhere from $5 to $15 
a week; but my experience with such nurses 
has been unfortunate, and I think the expe- 
rience of most of us would be similar. They 
are not efficient nurses; they have personal 
disabilities or something, as a rule, that unfits 
them for good nursing service; and I feel 
sure that the training of attendants would be 
followed by a long list of similar difficulties. 

And then, too, because people are poor does 
not signify that they want poor service, or 
that they should be given poor service. In 
the majority of instances they need the very 
best service; that is, they need nurses who 
not only have had a good deal of training, 
but who have the qualities of mind and heart 
that make it possible for them to enter into 
the lives of these people and see what they 
need, and do as good work as if they were get- 
ting $25 or $30 a week. So it seems to me if 
the schools of to-day could be augmented, if 
they could have a larger number of pupils, if 
further inducements could be made for a good 
class of women to enter the service, and a 
certain proportion of them could be used, par- 
ticularly in the cities, in undergraduate work 
outside, the service that could be given to the 
community would be almost unlimited. Of- 
course that means an endowment for the 
school, but why should not nursing schools, 
as well as other schools, be endowed? They 
need it; the opportunity is here, and there 
is a constant demand on the part of the 
public for the work these women can do. 
Now, if this can be made prominent enough 
so that those who have the means to endow 
such schools can be brought to see the neces- 
sity, I believe that the work can be accom- 
plished; but, of course, it can only be accom- 
plished through constant agitation and 
through the working toward some definite 
aim. 

Now, this report, for instance, is a definite 
report, and to my mind it is one of the best 
things that has ever been put forth. We 
should certainly from this be able to define 
what a training school is, what constitutes a 
training school for nurses. 

Schools, as well as nurses, should be regis- 
tered. It is important that we know where 
pupils graduate, what sort of service and op- 
portunities they have had. Perhaps in the 
course of a few years the whole thing may 
become systematized to such an extent that 



ADVERTISEMENTS 



122 



THE TRAINED NURSE AND HOSPITAL REVIEW 



all these questions can be answered. There 
is nothing impossible! It simply means a 
knowledge of what we want, and the working 
toward a definite end, and the final accom- 
plishment 

The graduating exercises of the Danvers 
Hospital Training School were held June 2^. 
The feature of the program was the adiress 
to the graduates by the retiring supvrintend- 
ent, Dr. Charles W. Page, who spoki* on the 
newer and more humane ihethods in the care 
of the insane. Brief remarks were niado i>y 
Dr. Henry M. Swift, and the valedictory was 
given by Miss Lillian E. Scott. Mr. S. 
Herbert Wilkins, chairman of the Board of 
Trustees, presented diplomas to the follow in j^ 
young women : Marie Ivarson, Mary Lillian 
Kerans, Vinora McClure, Minerva Pamelia 
Paquet, Lillian Ethel Scott. 

+ 
Changes (in Navy Nurse Corps. 

APPOINTMENTS *. 

Maude L. McKennie, graduate of the 
Brooklyn Hospital Training School; Telia B. 
Erwin, Lakeside Hospital, Cleveland, Ohio; 
Mary R. Gillette, University Hospital, Phila- 
delphia, Pa.; Lily E. White, St. Vincent's 
Hospital, Norfolk, Va.; Ruth R. Kuhn, Uni- 
versity of Maryland Hospital, Baltimore, Md. 

TRANSFERS : 

From the Naval Hospital, Norfolk, Va., 
Thomasina B. Small, to the Naval Hospital, 
Mare Island, California, and Mary C. Nelson, 
to the Naval Hospital, Brooklyn, N. Y. From 
the Naval Medical School Hospital, Wash- 
ington, D. C, to the Naval Hospita^ Norfolk, 
Va., Sara M. Cox and Sara B. Myer. 

Esther V. Hasson. 

+ 
Changes in Army Nurse Corps. 

APPOINTMENTS ; 

Joan R. Annand, graduate of Watertown 
City Hospital, Watertown, N. Y. : Minnie E. 
Kuehl, Grace Hospital, Boston, Mass., post- 
graduate of Bellevue Hospital, New York 
City; Etta M. Staub, Episcopal Hospital, 
Philadelphia, Pa. 

reappointment: 

Mary E. Nagle, Erie County Hospital, 
Buffalo, N. Y. 

discharges: 

E. Marie McGinty, June 9, 1910; Maude A. 



MacLellan, June 15, 1910; Alice G. Mahoney, 
June 17, 1910; Frances M. Steel, June 21, 
1910, Bessie C. Osbaugh, June 19, 1910. 

transfers : 

From General Hospital, San Francisco, to 
Ft. Bayard, New Mexico, Victoria E. Arm- 
strong, Leonora Bricker, Mary C. Jorgensen 
and Mrs. M. Virginia Himes. From General 
Hospital, Ft. Bayard, to San Francisco, Cali- 
fornia, Josephine Anslyn, Louise Rohlfs and 
Emma Woods. From San Francisco to 
Philippine Division, on Logan, June 6, 1910. 
Dollie Ann Bowzer and Mrs. Adjie H. Chap- 

"^^"- Jane A. Delano, 

Superintendent Army Nurse Corps. 

* 

+ 
New York. 

The Frederick Ferris Thompson Hospital, 
of Canandaigua, was the scene June 8th of 
a large gathering of people, including physi- 
cians, county officials and invited friends of 
the members of the first class of graduates of 
the Hospital Training School. The exercises 
were interesting and appropriate. 

After prayer by the Rev.Livingston L. Tay- 
lor, the Hon. Robert F. Thompson made an 
address in which he exalted womanhood and 
motherhood. 

The address to the. graduating class was de- 
livered by Dr. John H. Jewett, chairman of 
the Executive Committee of the hospital. 

Rev. Rogers Israel, D. D., of Scranton, Pa., 
was the next speaker. 

After paying tribute to the Memorial Hospital 
and to the devoted and able work of the su- 
perintendent, Miss Kraemer, he addressed a 
few earnest words to the members of the 
graduating class, dwelling particularly upon the 
duty of faithfulness. He then gave them the 
impressive pledge with which they enter upon 
their work. 

Diplomas and pins were presented to the 
members of the class, with brief but appro- 
priate words, by Mr. Edward G. Hayes, presi- 
dent of the Board of Directors of the hospital, 
and Dr. Israel pronounced the benediction. 

A delightful feature of the exercises were 
several selections of music rendered by the 
Ludwig Schenck Orchestra, of Rochester. 

The class thus graduated was made up of 
the following named young women: Margaret 
F. Bradley, of Scranton, Pa.; Caroline E. 
Nicholson, of Chapin ; Mary G. Savage, of 



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When you write Advertlaera. please mention Thb Tkunbd > 



124 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Seneca Falls; Edna N. Hicks, of Phelps, and 
Grace L. Stoek, of Washington, D. C. 



The Alumnae Association of the School of 
Medical Gymnastics and Massage, New York 
City, had its closing meeting for the season 
in June. The meeting was large, and a beau- 
tiful alumnae pin was selected. The gradu- 
ates are conducting the hospital and school 
clinics during the Summer months. 

The Fall class opens September 6. 



The members of Camp Roosevelt were en- 
tertained on the afternoon of Thursday, July 
7, at the home of Miss Edith Abrams, 115 
West One Hundred and Twenty-seventh 
street. After the regular business meeting a 
social hour was spent and refreshments served 
by Mrs. Abrams in her always charming, 
.hospitable way. The pext meeting will be 
held on August 4 at 596 Lexington avenue, 
notices of which will be sent out. All S. A. 
W. nurses are cordially invited to be present. 

+ 
Vepmont. 

The annual meeting of the Fanny Allen 
Graduate Nurses* Association was held at the 
hospital in Winooski, Vermont, on Tuesday, 
June 14. 

The meeting was called to order by the 
president. Sister McDonald, and the usual 
routine business transacted. The reports of 
the secretary and treasurer were read and ac- 
cepted, and showed the association to be in a 
-flourishing condition. 

Dr. Lyman Allen, secretary of the hospital, 
gave a very interesting and instructive talk 
"On the duties of the nurse in private work." 

Unity was the subject treated briefly by 
Sister McDonald, the president of 1909-1910. 

The election of officers followed, and Miss 
Margaret Connors, Class cf 1903, was chosen 
president; Miss Anna Kingston, 1905, vice- 
president; Mrs. Rose A. Lawler, 1907, secre- 
tary (re-elected), and Rev. Mother Steere, 
the Superior of the hospital, treasurer. 

Miss Blanche Parker, in a graceful little 
speech conveying the love and good wishes of 
the association, presented a large bunch of 
flowers to the retiring president, Sister Mc- 
Donald, and the secretary. Sister M. Collins. 

A social hour followed and a most beau- 
tifully prepared luncheon was served by Miss 
Sarah T. Whitmarch, Miss Alice Flynn, Miss 
Alberta Thomas and Miss Gertrude Donovan. 



The meeting adojurned, with expressions of 
enjoyment and good will from all present, to 
meet in 191 1. 

The Graduate Nurses of the Fanny Allen 
Hospital, in Winooski, Vermont, met at the 
home of Mrs. O. P. Joly, No. 18 Asit Place, 
and showered Miss Anna Kingston, a most 
popular young nurse, with a number of really 
beautiful gifts in honor of her approaching 
marriage with Doctor Leo Larner, of Hines- 
burgh, Vermont. The band then took pos- 
session of the bride-to-ibe and escorted her to 
Dorn's Cafe, and Miss Kingston will remem- 
ber for many years not only the banquet 
spread out for her enjoyment, but the heart- 
felt toasts for her future happiness and wel- 
fare, and as a further reminder the nurses will 
present her with a flashlight picture of the 
merry group. Miss Kingston is a graduate of 
the Fanny Allen Hospital Class of 1906. Dr. 
Larner is a graduate of the University of 
Vermont. 

+ 

Connecticut. 

The Graduate Nurses Association of Con- 
necticut held its seventh annual meeting at 
Wright Hall, Hartford, on May 4- The meet- 
ing was called to order by Miss M. J. Wil- 
kinson, president, at 3 p. m., after which the 
reports of the secretary and treasurer were 
read and accepted The report of the chair- 
man of the Membership Committee showed 
great activity on the part of this committee, 
a large number of new members having joined 
the association during the year. 

After the president's address the following 
officers were elected for the ensuing year: 
President, Miss M. J. Wilkinson, Hartford; 
First Vice-President, Mrs. L A. Wilcox, Pine 
Meadows; Second Vice-President, Miss E. A. 
Somers, Waterbury; Secretary, Mrs. Winifred 
Ahn Hart, Bridgeport; Treasurer, Miss Mar- 
cella T. Heavren, New Haven; chairmen of 
the standing committees: Ways and Means, 
Miss R. I. Albaugh, Pleasant Valley; Print- 
ing, Miss Fitzgerald, Hartford; Membership, 
Miss A. H. McCormac, Hartford; Legislative, 
Mrs. E. B. Lockwood, Granby. 

Following the introduction of the new of- 
ficers to the members, the meeting was 
adjourned, and at 6 p. m. the first annual 
dinner was held, twenty-seven members be- 
ing present, every one voting the affair a 
great success. 



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Our Bacteriological Wall Chart or our Di£Ferential Diagnostic Chart 
will be sent to any Physician upon application. 



, IM^M^ . H„^ ■ ^ . I„I„^ ■ |M^nI„^„^„In|n^ ■ ^ , t , ^M^ . ^ ■ ^ ■ ^ ■ IMI M ^ ■ |n|n^ „ ^ „ ^MI„|M^ ■ ^ . ^„I„I„^ . ^ ,■ ;MIM|„^»^ ■ I ■ ^ ^ 



A Drink in Fevers 



f 



A teaspoon of Horsford*s Acid Phosphate added 
to a glass of cold water makes a cooling and re- 
freshing acidulous drink for the patient during con- 
valescence from typhoid and other febrile condi- 
tions. 

Its superiority over Dilute Phosphoric Acid, or 
any other acid, is due to the fact that it contains 
the phosphates of calcium, sodium, magnesium 
and iron, v^hich means increased nutrition. 

Horsford's Acid Phosphate 

is more palatable and strengthening than lemon- 
ade, lime juice or any other acidulous drink. 

RUMFORD CHBMICAL WC^tKS, Providence, R. I. 



■ i"i"i"H"i"i-i"i ^ ■ ^ ■ H ■^ ^ ■ ^ ■ | .■ ^ ■ ^ ■ ^ ■ | »« | ■ | ■l | ■■ I ■■ | ■■ | .■ ^ ■ ^ . | ■■ H ■■ ^ ■i I ■■ ^ ■■ ^ ■■ ^ ■ ^ ■■ ^ ■■ | ■■ t ■■ ^ ■ ^^ ■ ^ ^ ^ ^ I"I ^ a ^■ ^ ■ ^1 ■^ ^ 

Wlien you write Advertisers, pleajse mention Thb Teainbo NuBsa 



126 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Red Cross. 

At a meeting of the New York State Com- 
mittee on Red Cross Nursing Service, held at 
the Central Club for Nurses, 54 East Thirty- 
fourth street, June 21, the following nurses 
were appointed members of the Manhattan 
local committee: Mrs. £. G. H. Schenck, 
chairman; Mrs. C V. Iwiss, Miss A. Charl- 
ton, Miss Elsie Patterson, Mrs. F. Brockway, 
Miss A. Ward, Miss Blackman and Miss Rose 
Johnson, secretary. 

The following nurses have been appointed 
members of the Brooklyn local committee: 
Miss £. Dewey» chairman ; Mrs. M. L. Rogers, 
Mrs. £. Ward, Mrs. A, Henricksen, Miss Ber- 
tha Cooper, Miss M. O'Donnell, Miss Hor- 
rocks, Miss Wall, Mrs. C. G. Stevenson and 
Miss Anna Davids, secretary. 

The Brooklyn local committee will have 
charge of all enrollments and Red Cross work 
on Long Island. The Manhattan committee 
will attend to all other enrollments and work 
throughout the State until the up-State com- 
mittees are appointed. 

Miss Rye Morley has been obliged to resign 
from the State Red Cross Committee owing 
to ill health, and Miss Kate I. Kennedy, of 
Buffalo, has been appointed in her place. 

The New York State Committee on Red 
Cross Nursing Service recommend all alumnae 
societies to appoint standing Red Cross com- 
mittees to keep in touch with Red Cross work 
and to secure the enrollment of their mem- 
bers in the Red Cross. 

At the last meeting of the State Red Cross 
Committee the secretary was authorized to 
write to the National Committee, Washing- 
ton, for instructions as to the desirability of 
undertaking medical emergency work during 
parades and large public meetings. 

+ 
Personal. 

Miss Inez C. Lord, of the Lowell (Mass.) 
General Hospital, has been appointed super- 
intendent of nurses at the Rhode Island Hos- 
pital, Providence, R. I. Her term of office 
begins September 15. 



Mrs. Maude Horner has resigned her po- 
sition as superintendent of the Woman's Hos- 
pital, Detroit. Miss Sydenham Melville, for- 
merly assistant supervisor of nurses at Ann 
Arbor, Mich., and later assistant superinten- 



dent at Columbia Hospital for Women, Wash- 
ington, D. C, has been appointed to fill the 
vacancy. She assumed her new responsibili- 
ties June I. 



Miss Robina Stewart, superintendent of 
nurses in Allegheny General Hospital, Pitts- 
burg, Pa., has been selected as successor to 
Miss Snively as superintendent of the train- 
ing school of the Toronto General Hospital. 
Miss Stewart is a Canadian, her home being 
in Guelph, and she is a graduate of the Johns 
Hopkins Hospital Training School for Nurses, 
where she served for some years in charge of 
the private wards. 



Miss Clara D. Noyes, superintendent of 
St. Luke's Hospital for the past nine years, 
has resigned to take the superintendency of 
the training school for nurses of Bellevue and 
allied hospitals of New York City. 



Miss Mary A. Samuel lias resigned her 
position as superintendent of Roosevelt Hos- 
pital, New York City. 



Miss Pauline L. Dolliver has been appoint- 
ed registrar of the Central Registry of New 
York City. 



Miss Anna L. Alline has been appointed 
superintendent of the Homeopathic Hospital, 
Buffalo. 



Miss Lavrnia L. Dock has announced her 
intention of putting aside everything but her 
journal and council work and devoting all her 
efforts to securing votes for women. Miss 
Dock believes this to be the only way to 
defeat the arch-enemy, man. 



Miss Mary C. Wheeler who for the past 
eleven years has served as superintendent of 
Blessing Hospital, Quincy, 111., has tendered 
her resignation to take effect June i. 

It has been said of Miss Wheeler that she 
has been an inspiration to her nurses as well 
as an instructor and has set them an example 
that they will never forget. Her executive 
ability, her remarkable energy and untiring 
industry, her close attention to details, and 
her warm, sympathetic nature have been felt 
in every department of the hospital, and the 






ADVERTISEMENTS 



1 



Therapeutic Dependability - 

.the unfailing: accomplishment of 
definite physiologic results — ^bas won for 

r Gray's Glycerine Tonic Gomp 

^■^ its recc^fnized place in the treatment of all forms of 

ftmctionai debility. Q When other tonics fail or are 
contra-indicated for one reason or another, GRAY'S 
GLYCERINE TONIC COMP. may be freely used with 
ihe constant assurance that its effects will ever be re- 
storative and reconstructive-iiever harmful or injurious. 




SMmptes and lifer»ture on raiaesf. 



Relieves 
Local 
Pain and 
Inflammation 

(Aoph blennllr) 

TRIAL 
PACKAGE 
ON 
REQUEST 

NOW SUPPLIED IN GLASS JARS 

r.™lp.,c„ G. W. CARNRICK CO. 

3Z. Gassjars-S .25 i^ lb. Glass Tars - |i .00 

'■ '■ " - .50 I 5 " " '• - 2.25 42 SULLIVAN ST., N.W York City 

WtMD you write Advertlsera, please mention Thb Tuinbd Numii. 



128 



THE TRAINED NURSE AND HOSPITAL REVIEW 



patients as well as the doctors, nurses and 
servants have realized the personal charm 
and rare influence of this capable woman, who 
has become so closely identified with Blessing 
Hospital that the Board of Managers are loath 
to have her go. 



Miss Lillian M. Rose, of Farmland, Ind., 
had been selected as successor to Mrs. Lillian 
Edgerly as superintendent of the hospital and 
training school at the State Soldiers* home, 
Lafayette, Ind. 



Miss Pearl Sturm has been appointed head 
nurse at the Logan Hospital, Logan, West 
Virginia. 



The Macon City Hospital is to have a new 
superintendent of nurses in the person of Miss 
Moran, of Philadelphia, who has been elected 
to that position. Miss Moran comes from the 
Philadelphia Hospital, where she has held the 
position of head of the operating room. 



Miss Mary E. Gompper, graduate of the 
South Milwaukee Hospital, South Milwaukee, 
has accepted the position of head nurse of the 
Grand Forks County Hospital, Arville, N. D. 



Miss A. F. Pehrson, graduate 1908, Wash- 
ington Park Hospital, Chicago, is now head 
nurse at Mercy Hospital, Kansas City, Mo. 



Miss Bessie L. Dickson, graduate '05, Chi- 
cago Policlinic Hospital, Chicago, has ac- 
cepted the position of head nurse of the Fannie 
C. Paddock Memorial Hospital, Taconia, 
Wash. 



Miss Clara L. Gross, graduate of Luth 
Hospital, St. Louis, Mo., has accepted the posi- 
tion of superintendent of nurses of the Fair- 
mont City Hospital, Fairmont, Va. 



Miss Norma Courts, graduate 1909, of Mary 
Thompson Hospital, Chicago, has accepted a 
position at the Chicago Home of the Friend- 
less. 

Resolutions. 

At the last meeting of the Alumnae Associa- 
tion of the Metropolitan Hospital Training 



School, New York City, annotmcemcnt was 
made of the death of Miss Cara J. Kenyon, of 
the class of 1899. A committee was appointed 
and prepared the following resolutions: 

Whereas, It has pleased God in His all wise 
Providence to remove from our midst our 
beloved friend and co-worker, 

Resolved, That we, the members of the 
Alumnae Association, have sustained in her 
death the loss of a valuable friend and loyal 
member, and that we tender her family our 
sincere sympathy. 

Resolved, That a copy of these resolutions 
be sent to the family and to the nursing 

magazines. 

Katherine a. Dillon, R.N. 
Helene D. Bengtson, R.N. 

Committee. 



Died suddenly, at Trafford, Pa., June 8, 
T910, Miss Martha McDeavitt, a graduate of 
the Columbia Hospital Training School for 
Nurses, Pittsburg, Pa., class of November. 

1909. 
Whereas, It has pleased Almighty God to 

remove from amongst us our beloved asso- 
ciate, Miss Martha McDeavitt, one of our 
most esteemed and useful members, one who 
was ever willing to help the work of the asso- 
ciation, therefore, her loss will be deeply felt 
by its members. Therefore, be it 

Resolved, That the members of the Alumnae 
Association of the Columbia Hospital Train- 
ing School for Nurses tender to the relatives 
of our deceased member their heartfelt sym- 
pathy. Be it further 

Resolved, That a copy of these resolutions 
be sent to her bereaved family, placed on thr 
minutes of this association and published in 
the Trained Nurse. 

LiLLTE Young, R.N. 

Margaret E. Graham, R.N. 

Mary E. Jones, R.N. 

+ 
Obituary. 

The death of Miss Grace M. Norman at the 
Levering Hospital, Hannibal, Mo., March 31st, 
was the first fatality that has ever occurred to 
a nurse at that institution. Miss Norman un- 
derwent an operation for appendicitis recently, 
and while the conditions were favorable at 
first, there was a sudden change which re- 
sulted in her death. 



ADVERTISEMENTS 



Tbe Presbyterian Hospital Nurses' Case 

A Complete wid Up^to-Datc Outfit 

Ond^c rf 1 Ivpadttndc aiint*. lilMt all n«I«l. with 
J attaim ud i ilih tor l»W«s. in jliunlnum «»; I n»ll 
Ola. 1 lOklplil, I dnKinc furapi, ] irnoTsl dliMtor 3 
rn^ l(ml, Bwi.1 c»tii«„, 2 ^ine infuHon nsedW 
!.,««. rT«*«, cmtjiwn-, 1 W«*«r't 1«[ UiSionnSr. t 



SM-indi uicnter 



L rf j n l c al Dotefl. irttioh ft 



d Of lUlc ■ 

8»aolftl PiKm, $10,00 

Bend Idt CaUlociiB 10 ot Modarn OooiU. 
Malm of dia oltt^ntcd Anlomatlo Bildnlii I^Us. 

THr MAX WOCHER & SON COMPANV 

ntfh Grade Hospital rurnltara mhI Supplic* 
19-21-23 W. 6lh St. aadna.lJ. Ohia 



lEMQUE 

■OWDER 



ANTISBPTEO 

CAMPHO-PHEMQUE 



aNPHO-PtlEMQUE 

POWDHa 



CAMPHO- 
PHCNIQUE CO. 

SOO ». U St.. 



When jrou write AdvartUen, pleue meotton Thi Trainh) Ndi 



■■OOKLINI, MASS. 



"Well, WeU! 

I bcw )«■ perfectly ne 

I BGAiR jam uywbti 
hftd &* AcouaclcGn ddw for 

b So >ari '« UKT t* 

mrtB jou bar dlitiKtlr 
TRY IT AT OUR EXPENSE" 



alistaOoilly tlw trill 



flpctricflj hcftrinv derjcfl. 



^etD l^emetites; a^ ^Itanced 



Sample Just Finel 

Canton, Ohio, Jan. 6th, 1910. 
Messrs. Ogden & Shimer. 

Gentlemen — Please send me one box Mystic 
Cream. Sample just fine. Yours truly, 

C. M. Wernet. 

+ 
Chocolate Glace. 

After making a glace frosting, dissolve one 
ounce of Walter Baker & Co.'s Premium No. 
I Chocolate in a cup, and put it with the frost- 
ing, adding also a tablespoonful of boiling 
water. 

+ 
In Seasickness. 

Listerine is very useful in the treatment of 
mal de mer. External applications of lister- 
ine, diluted with water, together with its in- 
halation from a handkerchief, will of|en re- 
lieve a nervous headache. 

+ 
Prefers Glyco-Thymollne. 

When intestinal antiseptics are indicated I 
prefer Glyco-Thymoline to anything I have 
ever used. I carry it in my case always and 
prescribe it with confidence. 

A. C. Brown, M. D. 
St. Louis, Mo. 

+ 

An Ideal Ointment Base. 

As an ointment base with which to incor- 
porate any active drug or preparation, no more 
desirable compound can be found than Un- • 
guentine, since it is non-irritating and never 
becomes rancid and, at the same time, pos- 
sesses sufficient astringent qualities to facili- 
tate rapid healing. 

+ 
Evacuant or Deobstruent Treatment. 

"The frequency with which cathartics or 
laxatives are required shows that there is 
indeed a broad field for the use of prunoids. 
Wherever evacuant or deobstruent treatment 
or even the more far-reaching effects of 
thorough elimination are indicated, this eligible 
pharmaceutical product will give uniform sat- • 
isfaction to both patient and practitioner.'* 



When a Tonic Is Needed. 

When a tonic is needed, there is none that 
will give more certain or uniform satisfaction 
than Gray's Glycerine Tonic Comp. For 
seventeen years it has been serving the pro- 
fession, and the esteem in which it is held 
to-day bears eloquent witness to its unvary- 
ing quality and efficiency. 

+ 
Ergoaplol (Smith). 

For irregular menstruation, amenorrhea, 
dysmenorrhea, etc., this product has worked 
a revolution in the treatment of this class of 
diseases. Despite the fact that it contains 
neither narcotics, opiates nor analgesics, it 
possesses remarkable properties for the relief 
of pain. 

+ 
Please Send Morel 
I am prescribing Resinol Ointment in many 
cases of skin diseases, also for scalds and 
burns. Since finding out its usefulness in 
itching cutaneous troubles, I could not get 
along without it Kindly send me more 
samples of both soap and ointment. 

S. S. Darill, M. D. 
Spartanburg, S. C 

+ 
Sal Laxa (Sharp A Dohme.) 

Since Sal Laxa produces watery movements 
of the bowels and also increases the flow of 
urine, it is applicable in dropsy due to liver 
or kidney diseases and in obesity. 

The metal cap that covers the cork protects 
the product. One teaspoon ful contains about 
90 grains of the effervescent salt. The adult 
dose ranges from one to four teaspoonfuls 
(90 to about 360 grains). 

+ 
Arrow Brand Linseed Oil Soap. 

It is the only cleaner that should ever be 

used on linoleum and oilcloth. Linseed oil is 

one of the principal ingredients of linoleum 

and oilcloth, and when ordinary soap, made 

from animal fat and containing an excess 

amount of alkali, is used the alkali attacks 

the linseed oil, causing the material to be- 



ADVERTISEMENTS 



INSTRUCTION IN MASSAGE 

THE SYSTEM YOU WILL EVENTUALLY LEARN 

Swedish Movements* Medical and Orthopaedic Gymnastics 

T«nns 3 Months Tuition Foo, $75.00 

Course In Electro-Therapy 

Tormi 2 Months Tuition Foo, $25.00 

Course In Hydro-Therapy In all Its Forms 

Torms 6 Wooks .... Tuition Foo. S30.00 

FALL CUSSES tpai la twt mritit : SEPTEMBER 21tt ut NOVEMBER 17tb, 1910 

Winter Classes Open Jsnuary 10th, 1911 

OVER 9000 TREATMENTS GIVEN IN 1909 
Mo mmttmr etintomt Mxpmifmttom ^omm»tm 

All conrtet msj be commenced at the tame time and finished within three months. 

The tneCniction oontists of daily clinical work and practical leaaonf on patients referred to our clinics from 
the rvrioat Hospital Dispensaries. Oritinal Swedish (Ling) system, and Weir Mitchell's Rest-Care system. 
All pupils attend clinics at scTcral city hospitals. Separate male ana female classes. Payments can be made 
tosnit your convenience. Winter Classes open January loth. 191 1. Particulars and illustrated booklet on 
Massasc upon request. As early spplicaties f er s d iwi sal os is sdvlsdble. 

INSTRUCTORS 



Wm.Egbbbt Wobbetsom.M.D. (Professor of Medi- 
cine. Temple University). 

MowAED T.KABSNsa.M.D. ]. (Instructors University 
HowAKD A. SuTTOV. M.D. i of Pennsylvania). 
Eloridgs L.ELiASON.M.D.dnstr't'rUniv.of Penna.) 

Louis H. A. von Cotzhausbn. Ph. G.. M. D. 
(Graduate Phila. College of Pharmacy, Med. Dept. 
University of Penna.. Penna. Orthopedic Institute). 

Wh. Ekwin. M.D. (Hahnemann and Rush Med. Col.) 



Max J. Waltbb (Univ. of Penna.. Royal Univ.. 
Bredau. Germany, and lecturer to St. Joseph's. 
St. Mary's. Philadelphia General Hospiul (Block- 
ley). Mount Sinai and W. Phila. Hosp. for Women. 
Cooper Hosp., etc.) 

Hblbnb BoMSDOByy (Gym. Ins..StockholmtSweden). 

LiLLiB H. Mabshall I (Pennsylvania Orthopedic 

Edith W. Kmioht / Institute). 

Mabgabbt a. Zabbl (German Hospital. Philadel- 
phia. Penaa. Orthopaedic Institute). 



Pennsylvania Orthopaedic Institute and School of 

1^ echano-Therapy (laM^veratad) 

nil Grcea Street, PHILADELPHIA, PA. MAX J. WALTEI, SiperiiteMieflt 



JW cBorax lodine^Bran ^Afr 

ACT5 LIKE MAGIC 

40 Years the Standard of Efficiencys 

Instantly Stops that everlasting Smarting, Aching and Foot 
Weariness. Dissolves Corns and Callouses. Soothes and re- 
moves Bunions and all Inflammations. Relieves and Prevents 
Excessive Perspiration. A triumph of medical skill. Worked 
out by William Johnson, graduate of the London Chemical 
Laboratory. One cake will demonstrate it. Buy a cake to- 
day and know what Foot Comfort means. 

Large cake, 25c. All druggists. Samples free on request. 

Money Back if Not Satisfied. 

WILBUR A. Vt^LCH, Sole Ditlribulor. - 905N Hatiron Building. New York 



Wb^n you write Advertlaers, plesuBe mention Thb Tbainid Nubib. 



132 



THE TRAINED NURSE AND HOSPITAL REVIEW 



come hard and brittle, and greatly shortens its 

lite. Arrow Lrnseed Soap not only cleanses 

thoroughly, but having linseed oil as a base 

tends to keep the linoleun^ or oilcloth soft, 

pliable and in good condition. 

+ 
Hay Fever. 

Horsford's Acid Phosphate in teaspoonful 
doses with water and sugar is highly recom- 
mended if taken for a few weeks previous to 
the attack. 

We feel confident in recommending this as 
a preventive for hay fever, if used as di- 
rected above. It is a powerful nerve tonic in 
cases of exhausted condition of the nervous 
system. 

+ 
Instead of Hot Water Bottles. 

Instead of hot water bottles the 50 C. P. 
special therapeutic lamp placed in a hood, so 
that all the heat rays are emitted, is now ex- 
tensively used in many hospitals where im- 
mediate and intense heat is desired. For ap- 
plying the same to joints, spine, abdomen or 
any special small area it has great value. The 
price now has been reduced to a point where 
all hospitals can purchase same. It is made 
by The Max Wocher & Son Co., of Cincinnati. 

+ 
Soothing Pelvic Neuralgias. 

For the purpose of soothing and controlling 
pelvic neuralgias the most satisfactory results 
can be obtained by the administration of 
Dioviburnia two parts, combined with Neuro- 
sine one part. You can depend upon your 
patients returning and expressing themselves 
that the medicine you dispensed caused their 
nervousness, etc., to abate, and request of you 
some more of the same. Doctor, give this 
combination a trial. 

+ 
Women and Weak Nerves. 

"Weak nerves," so called (or nervous de- 
bility, as it might more properly be called), 
are the source of a great deal of suffering, 
ranging from a slight headache to rnsanity. 
A little nervousness easily develops into 
hysteria and involves the entire system. The 
duty of a sedative is to reduce the tension of 
the nerves, and thereby either prevent its in- 
crease or soothe it into a normal condition if 
it has grown into a disease. Passifiora In- 
carnata is a natural sedative to nervous ex- 



citement, and seems peculiarly adapted to these 
cases, not only allaying irritation, but con- 
trolling the entire organism. The only reliable 
preparation is the Concentrated Tincture, 
manufactured by John B. Daniel, Atlanta, Ga. 

+ 
Papine. 

In all forms of diarrhea and dysentery — 
when it becomes necessary to allay excessive 
peristalsis, overcome spasm and control pain, 
there is no remedy that gives as uniform sat- 
isfaction as Papine. The sedative, analgesic 
action of this remedy is manifested immedi- 
ately, and the characteristc tenesmus is re- 
lieved almost as promptly. Here, again, the 
recovery of the patient is not interrupted by 
the customary severe constipation by which 
the use of other opiates is commonly fol- 
lowed. 

+ 
How to Enjoy an Outing. 
There are many uses for antikamnia tablets, 
not usually thought of. Patients who take an 
antikamnia tablet before starting on an out- 
ing, tourists, picnicJcers, automobilists, bicy- 
clists and, in fact, anybody who is out in the 
sun and air all day, will entirely escape that 
demoralizing headache which frequently mars 
the pleasure of such an occasion. This ap- 
plies equally to women on shopping tours, and 
especially to those who invariably come home 
cross and out of sorts, with a wretched "sight- 
seer's headache." 

+ 
Extracting the Principles of Cod Liver Oil. 
In Hagee's Cordial of the Extract of Cod 
Liver Oil Compounds the active principles of 
cod liver oil are extracted from the whole 
product, thus saving the stomach the task of 
digesting the oil for the sake of the medicinal 
properties it contains. When it is remem- 
bered that the whole oil will frequently upset 
a normal stomach, this feature of Hagee's 
Cordial of the Extract of Cod Liver Oil Com- 
pound at once stamps it as the most reliable 
and palatable cod liver oil preparation to 
prescribe. 

+ 
The Anemia of the Nephritic Patients. 

It is pretty generally conceded by author- 
ities and clinicians of experience that a bland 
milk diet is best suited to the needs of the 



ADVERTISEMENTS 



Philadelphia Orthopaedic 

Hospital and Infirmair 

for Nerroas Diseases 



■Ri* nmADELPHlA ORTHO- 
PAEDIC HOSPITAL AND INRRM- 
ARY FOR NERVOUS DISEASES. i> 
wbkh initniction in mttufe, correcliTa aad 
TC-cdiKalioMl gyniiuulic* Iw* been pna foi 
tflccn yun, aow prapoMt to extend and 
•alariB A* icapa of due ttachlag, ■«] cffui 
a coanc ii tboe lubjecl) wtiicli il M baCtrcd, 
widi the sreal Tiriely and qnandtr ti mate- 
rial for obaenalian and pnctice al die St- 
poMl of ihc hfMpital, caaao* ba eqnaUd m 
thn cDUDlrj. 

Dnnii Af jti 190B dw aiBbcr 
treatanenli givco in dw out-patient de| 
b; pnpifc in the manage and aie(£ca]' 
conne exceeded ten ifaotuand. Bedde* 
adrasced piqwli haTe oppottirailia of gr 
■eoecal and qMciaJ Baiwaga to patienb in 



The nibjecli cavered hf die eouna wiD ii 
elude iulnictioB m die (reaimat b; mamtt 
»f general diieaM* af nutrition, neurailhenii 
bjileria, chorea, etc., and hj nuwage nod a 
ercne in eerebial and ipbaJ paralyni, iafai 
tile pab;. traumatie injuria of die tpinat cori 
ihlocadoni, joint adbcMau, diiabiHtiet fo 
lowing fiactuR*. bumi, tear*, etc.; ai^ 
currature and adier potlural defonnitief, fli 
foot, dub foot contrncturca and die h 
of 



The uutTuction wiU occupy about Mvm 
monlhi, beginnmg in October, 1909. Lactnrei 
will be pn- br Dr. J. K. Mitchell, Dr. Wm. 
J. Tayki, Dr. G. G. Davit, Dr. Frank D. 
Dickwn and Dr. Wm. }. Drajton. Jr., wbila 
the practical '"■■♦■"'i occupiet from direa to 
four hour* dail]'. 



TloK dewToui of entering the cIbm, which 
will be limited in number, diould apply to the 
■nperinteiidenl of die koapital, who will lend 
a circular witb detailt of the rBquiremcnti for 
admiMioa. The fee (or diie courw it $100. 

A iborler coune of intmction in die diera- 
peu& Biei of Electricity, witabla for pnfnk, 
may be taken with die mechano-thei^iy or 

Thii couna tait (our montfai, and die fee 
ii $25. 



1701 Sammer St» Phila., Pa. 



One of above special bottles of 
QlycO'T bymollne will be sent 

FREE 
Express Prepaid 

to any Iralned Nurse on appli- 
cation. 

We want you to know the value 
of Qlyco-Thymotiae. ItstoniJs 
on its merits. 

Mention thil Magazine. 

KRESS & OWEN qpMPANY 

210 Fulton St., New Vnrk. 



When you write Aavertiaers, please mentton Tk» Tbainid Nubbb. 



134 



THE TRAINED NURSE AND HOSPITAL REVIEW 



nephritic invalid. It is well known, however, 
that milk contains but an infinitesimal propor- 
tion of iron. This deficiency can be readily 
made good by administering Pepto-Mangan 
(Gude) both during and after the milk diet 
period. This palatable, organic, ferruginous 
compound is entirely free from irritant action 
upon the kidneys and it does not disturb the 
digestion or cause constipation. The essenrlnl 
iron is supplied in tolerable and promptly as- 
similable form and the use of the remedy 
does not, in any way, interfere with such 
other treatment as the physician may see fit to 
adopt 

+ . 

Nutrient Features. 

Hor lick's Malted Milk is prepared on phy- 
siological lines, under modern hygienic pre- 
cautions, and in the light of over a quarter 
of a century of experience. Its basis is a 
generous proportion of pure, rich milk, ob- 
tained from dairies that are well regulated, 
special precautions being taken to insure both 
purity and nutritive value. The milk is en 
riched with albumenoids, carbohydrates, phos- 
phates and other extractive matter, obtainec' 
from select wheat and barley after being 
malted in a scientific manner in our own 
malt house, under expert supervision. 

+ 
Maintain Nervous Poise. 

In approaching maternity cases, the main- 
taining of nervous poise presents such a 
problem that ordinary means are out of the 
question. 

On account of this the use of a malt ex- 
tract has come to be regarded as the "great 
deliverer" during this trying period. 

Of course, having a reputation to guard, 
one wants to be sure that one is prescribing 
a reliable brand. On this account it is no 
wonder that nine of every ten practition- 
ers specify Pabst Extract, the "Best" Tonic, 
for it has stood for fifty years for all that 
is pure, clean and uniform. 



presence of synergistic drugs, we do not 
know, but Thalosen is certainly more satisfac- 
tory in its action than the phenolphthalein 
laxatives that have come from other sources. 
In this combination one grain of phenolphtha- 
lein seems to go farther and operate more 
completely and regularly than twice the dose 
of this drug given alone or in other com- 
binations. 

+ 

Use It Every Day. 

Dr. Frank Billings, in a statement before 
the Committee on Manufactures of the United 
States Senate, in speaking of Borax, says: 
"As far as its medicinal effect is concerned, 
we use it in meditine, outside of surgery, very 
much for the purpose of neutralizing acids and 
cleansing surfaces. I use it every day, for 
instance, in stomach disturbances, washing 
out stomachs, putting from i% to 5% of it 
in water to render the water slightly alkaline 
and to remove the mucus from the surface 
of the stomach, and also to neutralize tht 
acids — any abnormal acid which may be there 
— and I use it with impunity." 

+ 
More and More in Demand. 

Postum, the now quite famous breakfast 
beverage made by a special process from 
clean, hard wheat, is more and more in de- 
mand by those who find discomfort from the 
use of coffee. After all, why use a beverage 
like coffee and tea, both of which contain a 
true habit- forming drug— caffeine? Wren 
Postum is thoroughly boiled and is served 
with cream it is often impossible to detect 
the difference between it and coffee. Yet it 
contains no coffee or other harmful substance, 
being made, as above mentioned, of wheat, 
including the bran-coat which contains the 
valuable mineral matter (phosphate of pot- 
ash) so essential to cell elaboration. But 
Postum is not agreeable unless boiled accord- 
ing to directions in package — at least 15 min- 
utes and serve hot with cream. 



Thalosen (Abbott). 

Each tablet contains one grain of phenol- 
phthalein with senna and sulphur in correct 
proportions, in an aromatic base. For con- 
venience it is segmented into quarter doses. 
Whether it is because a refined grade of the 
drug is used in its making, or because of the 



Sturm Signal System. 

There is but one perfect hospital signal 
system. This system was devised by Meyer 
J. Sturm, hospital architect, for use in the 
hospitals and institutions designed by him for 
the purpose of calling nurses and attendants. 

There can be no confusion of calls with 



ADVERTISEMENTS 



20 Mule Team Products 

For tho Nwtery and SIcHbob 

BORAX is one of the mildest antiseptics 
known; in fact it is comparatively the 
only one known that is wholly safe to use 
in the sick room. Therefore, it can be used 
in the place of more powerful antiseptics, 
which are frequently the cause of poisoning 
a patienL 

Borax can be used indiscriminately in the 
sick room for softening water with which to 
bathe the patient, and for thoroughly cleans- 
ing bed linen, soiled garments and utensils. 

A boric acid solution is cooling and soothing 
for the eyes, for inflamed cuticle or the mu- 
cous membrane. Boric acid spangles are the 
best to use for making a solution. Boric acid 
in a powdered form is unsurpassed as a dust- 
ing powder. 

20 Hule Te«.m Borax, Borlo AaU and Sp&n- 
Blea are all pack«d In convenient cartons Cor 
the Durae to handla. Tho 20 Hule Team 
Brand ]■ always a guarantee ot purity. 

Wrlta for ow "Uagto Oryttat' bookfat — /rea 



PACIFIC COAST BORAX CO. 

N«w York Chicago Oakland 



Help Wanted? 

Would a quiet, efficient and unobtrusive assistant be accept- 
able to you during the long, nerve-trying hours of duty^-an assist- 
ant that would relieve you of one-half the routine part of your 

The R.R.R. helps for nurses will render yon just such assist- 
ance — ever^ one is a specialist in its own particular field, meeting 
every requirement of modern nursing. 

One of these helps is shown in this advertisement— 

The R. R. R. Thermometer Set— Mouth, 
Rectal and Bath Thermometers 

In a Combination Caao 

that will insure your readiness for all thermometer emergen- 
cies. It will PAY YOU to know about the R.R.R. method ot 
replacing broken thermometers. 

The R,R-R- helps also include charts for every purpose— bed- 
side, maternity and T. P. & R.— and the READY REFERENCE 
REGISTER, the history of your own personal experiences. 

You are entitled to a free and complete set of samples of these 
"Silent Sick-room Assistants;" to get them just write "Please 
send samples ot the R.R.R." over your name and address on a 
postal. Address the postal to 

THE READY REFERENCE REGISTER 

Herald Bulidlns WATCRTOWN. N. V. ^^^^ Apw^r™ 

Wk«n rou wTlta Advertlaen. pleaae mention Thb Tumv NUUS. 



136 



THE TRAINED NURSE AND HOSPITAL REVIEW 



this system. No mistakes can be made. It 
is positive and quiet. There are no btlls, 
annunciators, drops or miniature lamps. All 
signalling is done by ordinary electric lights 
operated from the bed of patient. Signal 
lights cannot be turned off except by nurse or 
attendant going to the bedside of person wlio 
called. Pilot lights cannot be extinguished 
until all calls on any floor have been 
answered. 

See advertisement in this issue. 
The Relay Signal Company, 

86 La Salle Street, Chicago. 111. 

+ 
New Remedies. 

If figures really talk, we must certainly 
believe that mechanical treatments of all de- 
scriptions are growing, not merely in the 
favor of the laity, but also in the favor of 
physicians and hospitals. Almost 10,000 
mechanical treatments were given in the last 
year at this institution alone, and nearly 400 
of our graduates have accepted institutional 
positions either to take charge of the mechani- 
cal departments at hospitals and sanatoria, or 
as instructors to the nurses in the various 
branches of Mechano-Therapy. 

The Pennsylvania Orthopaedic Institute and 
School of Mechano-Therapy (Inc.), 171 1 
Green street, Philadelphia, Pa., offers to ear- 
nest men and women a carefully prepared 
and most complete course in the Swedish 
system of Massage, Medical, Corrective and 
Educational Gymnastics, Electro and Hydro- 
Therapy, also em-bracing the subjects of 
Anatomy, Physiology and Pathology as far 
as required for this line of work. 

The students do not only get a thorough 
practical and theoretical course in the branches 
mentioned but are sent to the leading hos- 
pitals of the city to give such treatments to 
patients in the nervous and orthopaedic dis- 
pensaries. 

Upon completing the course, lasting three 
months, the institute assists its graduates in 
obtaining institutional positions, as well as 
private work, and particularly in the last year 
the call for competent graduates has been 
far in excess of the number of available ap- 
plicants. 

It is needless to say that this profession is 
dignified and remimerative, and any one in- 
terested in taking a course will find it to their 
advantage to inquire further into the matter 



by asking for an illustrated prospectus con- 
taining the necessary particulars. 

The Summer classes open July 12. The 
Fall classes will open in two sections, on 
September 21 and on November 17. The 
Winter class opens January 10, 1911. 

Kindly address all communications to Max 
J. Walter, Superintendent. 



Card Register Systems for Hospitals. 

In every hospital there is the need of a 
practical registering device, not only for the 
recording of patients, but also to keep track 
of the coming and going of nurses and phj^si- 
cians. 

The Universal Register Company of Chi- 
cago manufacture a complete line of registers, 
all of which are constructed with a view to 
furnishing the most convenient and practical 
service. They have the advantage of several 
years of catering to the hospital trade, and 
their line is receiving wide recognition among 
the best hospitals. 

The Hospital Patients* Register is so con- 
structed that all information regarding the 
various patients can be seen at a glance, while 
their "*In and Out" registers for physicians 
and nurses are most simple in operation and 
cover all requirement. 

The pocket of the nurses' "In and Out" reg- 
ister accommodates a card sufficiently large 
to permit of a synopsis of each case being 
written on the lower half of the card, the 
card pockets of the board being so arranged 
that when the card drops into the pocket only 
the upper portion of the card showing the 
nurse's name appears to view, the lower por- 
tion of the card dropping out of sight. Thus. 
to the casual observer, the only information 
that appears to view is the name of the nurse, 
and only those authorized to take the card 
out of the pocket would be in a position to 
know the nature of the case. 

The "In and Out" register for physicians 
has quite a different style of pocket, and does 
not accommodate as large a card, as it is 
necessary to show only the name. . 

Full particulars will be cheerfully furnished 
upon request. Communications should be ad- 
dressed to the Universal Register Company at 
their main office and factory at 1409 Wes: 
Jackson Boulevard, Chicago, or their branc'i 
office at 92 Centre Street, New York. 



ADVERTISEMENTS 



€i)e ^tilbltssiier'sf Besik 



A MonlMy Magazine Devoted to Trained Nuning m 
Private Practice and in the HotpitaJi of the CouiA^ 

Editor 

ANNETTE SUMNER KOSZ 

LAKESIDE PUBLISHING COMPANY 

PUBUSHERS 



OFnCEr-114-116 Eaat 28th SU New York City 

THE TRAINED NURSE 

has no firee circulation. Itt price is $2.00 a year, and 
it is worth it It is published in the interest of the 
profession, screens no swindlers* putfi no humbugi, 
and does not take half ilispace to tell how good the 
other half is. 

Annual Subscription, post-paid $2.00 

Single Copies .20 

SnUrtd as steand-clasM matUr mi ths Ntw York PoU 
Ojffict» March I4ik^ toot. 

IMPORTANT NOTICE.— Those of our subscrib- 
ers who wish to notify change of address must send 
such notification in order that it may reach the pub- 
lishers not later than the 20th of the month before 
fMiblishing; otherwise the change cannot be made. 

COMPLAINTS for non-receipt of copies or requesb 
for extra numbers must be received on or before 
the 1 0th of the month of publication; odierwise 
the supply is apt to be exhausted. 

TO CONTRIBUTORS.— We pay liberaUy for aU 
Original Articles. 

Exclusive publication must be insured to all 
contributions offered to the Editors. Rejected man- 
uscripli will be returned if stamps be sent for this 
purpose. 

Exclusive publication not required for contribu- 
tions to Nursing World Department 

Illustrations for articles are particularly solicited. 
An expense for drawinpy plates, etc, will be borne 
by the publishers. 

No responsibility is accepted by the Editors or pub- 
lishers for the opinions of contributors, nor are diey 
responsible for any other than editorial statements. 

Books and monographs will be reviewed promptly. 

Short, practical notes upon personal experiences 
or brief reports of interesting cases, with results 
from remedies, new or old, will be welcomed. 

The Editors and printers will greatly appreciate 
die courtesy of having all manuscript typewritten; 
or, if this u impossible, clearly written, great atten- 
Son being given to pnper names and medical terms. 

CopyrighK. 1910. by Lakeside PtfblMiing Company. 



Awaiting Review. 

We regret that lack of space has prevented 
us from reviewing a large number of exceed- 
ingly interesting books now on hand. 

Among others are: 

Emergency Surgery for the General Prac- 
titioner, by John W. Sluss, A.M., M.D., Pro- 
fessor of Anatomy, Indiana University School 
of Medicine; formerly Professor of Anatomy 
and Clinical Surgery, Medical College of 
Indiana; Surgeon to the Indianapolis City 
Hospital, Surgeon to the City Dispensary, 
member of the National Association of Mili- 
tary Surgeons. Second edition, revised and 
enlarged, with 605 illustrations, some of which 
are printed in colors. Price $3.50. 



How to Become a Nurse. The Nursing Pro- 
fession, How and Where to Train. Being a 
guide for trained nurses in their work and 
to training for the profession of a nurse, with 
particulars of nurse training schools in the 
United Kingdom and abroad and an outline 
of the principal laws affecting nurses, etc., 
edited by Sir Henry Burdett, K. C. B., K. C. 
V. O. New and revised edition, thirtieth 
thousand. Price $1.00. Scientific Press, Lon- 
don, England. 



The Midwife's Pronouncing Dictionary of 
Obstetrical and Gyneacological Terms, edited 
by Henry Robinson, M.A., M.D., Anaesthetist 
to the Cancer Hospital and to the Samaritan 
Hospital for Women; late Resident Obstetric 
Officer at ■ St. George's Hospital, etc. Price 
50c. Scientific Press, London, England. 



Cosmetic Surgery. The Correction of Feai- 
ural Imperfections, by Charles C. Miller, M.D. 
Second edition, enlarged. Price $1.50. 



Health in the Home, a practical work on 
the promotion and preservation of health, 
with illustrated descriptions of Swedish 
gymnastic exercise for home and club prac- 
tice, by E. Marguerite Lindley, Lecturer on 
Health-Culture. New and revised edition. 
Price $1.00. 

All of these are for sale by the Lakeside 
Publishing Company. 



CJe Cratneti j^utfife arm 



VOL. XLV. 



NEW YORK. SEPTEMBER. 1910. 



NO. 3 



CJe ISitsponQiUlitm of Sour ^^ocation 



JOHN C. Mac ®VITT, M. D. 



PrcBldeni of the Medical Society of the County of Kings. New York. 



HOW typical of your hospital life has 
been the month through which we 
have just passed, April — filled with sun- 
shine and shadow. How auspicious for 
these gladsome exercises is the present 
month, May — radiant May, with its 
genial air tinctured with the perfume ot 
flowers, crimsoning the blood, sending 
it laden with buoyant hopes riotously 
coursing through your veins, its subtle 
energy lending elasticity to your step and 
animation to every movement. All na- 
ture is singing a pean of joy — Hymn of 
Awakening, and you to-night are singing 
the prelude to a new existence. Rejoicing 
with you and appreciating the honor that 
has been conferred upon me of extend- 
ing to you a congratulatory greeting and 
a parting benediction, I confess to a feel- 
ing of trepidation, a fear lest I should 
strike some jarring chord to mar the sym- 
phony — ^to a feeling of embarrassment 
equal in intensity to that of the good old 
Methodist preacher, who, having entered 
his pulpit, placed the roll of manuscript 
containing his sermon in a convenient 
knot-hole ; lost in the fervor of his open- 



ing prayer he accidentally pushed it into 
the hole beyond recovery; in dismay he 
abruptly ceased his prayerful supplica- 
tion and looking ruefully at the knot- 
hole and then at his bewildered congrega- 
tion, exclaimed: "My dearly beloved 
brethren, there is a mighty good sermon 
in that knot-hole, but you will have 
to get it out." So it is with me. I have 
thoughts within me which it will be 
necessary for you to bring forth. 

Yet, as I gaze upon the beautiful pic- 
ture of these comely young women, 
framed in the beaming countenances of 
this cultivated assemblage, I am sure 
were I an Egyptian mummy I would find 
sufficient inspiration. 

Young ladies, let your hearts beat ex- 
ultingly. This is your hour of triumph. 
You are now tasting the sweets of vic- 
tory, and we are here to exult with you. 
Lest you forget that you are to gird you» 
loins for a greater fray on the morrow 
I intend to add to my congratulations a 
few words of friendly advice. As it is 
befitting that a general skilled in war 
should on the eve of battle counsel his 



T^eUv^red to the GradnatlnK Class of Seney Hospital, Brooklyn, May 10, 1910. Contributed to 



140 



THE TRAINED NURSE AND HOSPITAL REVIEW 



soldiers, so it is befitting that a physician 
should counsel his assistants. The wis- 
dom of my selection may be questioned, 
for upon occasions of this kind it is 
customary for the speaker to deal in the 
license of poetic exaggeration. The lay 
orator, viewing you and your profession 
from its sentimental side, can in rhetor- 
ical flights of fancy describe in such 
glowingly picturesque terms the heroics 
and divinity of your art that you, in your 
exaltation among the clouds, might well 
wonder if it would be possible for you to 
descend to the menial duty of — oh, well, 
let us say, making a bed. I shall speak 
to you as a teacher of nurses, as a fel- 
low worker with them in the hospital 
wards, at the bedside of the sick in the 
sanctuary of private homes, as one who 
has heard them condemned, as one who 
has heard them praised. If inferentially 
I speak of your foibles, so will I of your 
virtues. Believe me, young ladies, you 
are not heroines, yet you are capable of 
performing heroic deeds. You are just 
plain, practical, self-respecting, self-sup- 
porting, independent young American 
women, holding by your moral character 
our respect, and by your skill our admi- 
ration. You have selected as a means of 
livelihood nursing as a profession, and 
a no'ble profession it is. You have 
chosen well, chosen as did Florence 
Nightingale fifty-six years ago. How 
musically that revered name falls upon 
our ears! What suggestive beauty lies 
hidden within its meaning! Nightin- 
gale, Singing Bird of the Night, whose 
song lends radiance to the darkness. 
How symbolical it was of her calling, foi 
where there is sickness a veil of mental 
gloom shuts out the joy of day. The 
kindred of the sick one wander helpless 
in its oppressive atmosphere. The nurse 

in her ministrations sings the song of the 



nightingale and the gloom melts beneath 
the melody of its strain. Somewhere 
within your innermost self there must 
have been born the germinal thought of 
compassion for and the desire to succor 
the sick and afflicted". Hence, then, your 
choice of a vocation has been by intui- 
tion, in the truth of which we bow in 
honor to you. Your three years' experi- 
ence within the hospital walls has un- 
doubtedly destroyed much of the ro- 
mance with which at first vou were im- 
bued. In its stead we will hope that 
there has been instilled a tender sympa- 
thy for suflFering, a |>atient forbearance 
with the exactions and irritability of the 
sick, and, above all, a knowledge of the 
great responsibilities which you elect to 
assume. To-night you sever the bonds 
of association which guided and safe- 
guarded you through your period of in- 
struction. To-morrow you take up du- 
ties sacred in the eyes of God and man. 
Confidences and secrets even dearer than 
life will be entrusted to your keeping. 
You would be lacking, then, in con- 
science if mingled feelings of courage 
and fear did not mark your entrance into 
this noblest of all vocations for women- 
nursing. 

I would like to dwell upon the story of 
its evolution, from the beer-drinking 
charwoman of the Victorian era to the 
intellectual, refined trained nurse of to- 
day. I would like to go back to the 
cloistered nursing of the humble an 1 
meek Sisters of Charity whose lives were 
sacrificed to this God-like quality of 
charity and mercy, and to the days of 
the divinely inspired St. Vincent de Paul ; 
but I must not tarry, I have more prac- 
tical things to say with the limited time 
at my disposal. Be modest in the esti- 
mation of your acquirements. Your 
knowlec'ge of medicine is most elemen 



RESPONSIBILITIES OF YOUR VOCATION 



141 



tary indeed. Amplify it along the lines 
of the study of systematology of disease 
and the physiological actions of medi- 
cine, for herein lies the knowledge of the 
greatest value to the patient and to the 
pjhysician. Cultivate a habit of study. 
Strive to live in an intellectual atmos- 
phere. You may be lacking in personal 
charms, but beauty of the mind shines 
with an ineffable charm and bears better 
the breath of time. Let your reading be 
diversified, but I beg of you to eschew 
the problem novel of the day and the 
prurient literature so voraciously de- 
voured by the public. The Lord knows 
we see enough of the filth and nastiness 
of life without seeking it elsewhere. 
Read books which will develop character 
and culture. A broad sympathy and love 
for all living things, books which will en- 
able you to interpret the voice of the 
forest pines, soothingly whispering to the 
turbulent waves as they angrily hurl 
themselves against the shore; works 
which do not drag women through the 
mire, but place them in their proper 
sphere among the stars to be worshipped 
as we worship our mothers ; books which 
treat of the doctrines of Him who said 
to the harlot, "Go and sin no more." 
Thus the dross in your nature will be re- 
fined and fit you intellectually and mor- 
ally to enter into the lives of others ; to 
minister to the sick; to wipe the sweat 
from the brow of the dying, and to kneel 
in the presence of the dead. 

The essential practical requirements 
for being a good nurse are multiple. 
When summoned to attend a case of sick- 
ness it is well to bear in mind that yours 
is a mission of mercy ; that your duty is 
to bring courage and fortitude into the 
afflicted household where anxiety and 
fear dwell; that your welcome is cause: 
by a necessity ; that you are to supplant 



in attendance the affectionate ministra- 
tion of some relative, perhaps a wife or 
mother, who, worn out by constant vigil, 
is a physical and mental wreck, who, 
while she courteously welcomes you, 
grudgingly, misgivingly and jealously re- 
signs her charge to you — a stranger. First 
impressions means so much. Let your 
garb be in keeping with your occupation 
— neat, modest and sober, your manner 
quiet, reserved and dignified. Disarm 
criticism by your dress and personality. 
I have known cases where the garishneSb 
of nurses* street attire, upon their 
introduction, produced a feeling of an- 
tagonism that faithful service failed to 
overcome. In the sick room try to avoid 
marked assumption of authority. From 
the first moment endeavor to win the 
confidence not only of your patient, but 
of the members of the household. Many 
people object to the presence of a nurse 
because of the fear of their banishment 
from the sick room. It is your duty, 
for the sake of your professional sisters, 
to overcome this prejudice by tactful 
cordiality. It is only in grave cases and 
by order of the attending physician that 
restrictions are to be placed upon the 
going and coming of members of the 
family. Do not be mysterious in your 
actions, but explain the simplicity of the 
things you do or are about to do. Re- 
member that amiability, prettiness of 
face, good-natured volubility, while not 
defects, are surpassed by a grave gentle- 
ness of demeanor, to know how and 
when to be silent and a softly modu- 
lated tone of voice. Learn to control 
your temperament; expressions of doubt 
or fear at unfavorable symptoms in your 
patient are quickly recognized and are 
productive of undue anxiety in others. 
In all homes there are secrets. The 
skeleton may be hidden within the dark- 



142 



THE TRAINED NURSE AND HOSPITAL REVIEW 



est recess of the closet, but in sickness 
in the family it generally stalks forth. 
Let what you learn in this confidential 
capacity be held inviolate; let the keep- 
ing of these secrets be the flowers which 
will bedeck your own grave. The State 
recognizes the sacredness of your call- 
ing and throws its protecting mantle 
over those confidences of which you 
have been willingly or unwillingly the 
recipient. To the physician in attend- 
ance be loyal. You may recognize his 
deficiencies, know that his professional 
standing is not above mediocrity. They 
who employ him have faith in his abil- 
ity. Never by innuendo or praise of 
other physicians destroy this faith. 
Your first duty is to your patient. If 
you are certain that injurious effects 
will follow the literal following out of 
the doctor's instructions modify them; 
obedience to orders is admirable, but let 
it be intelligent in its performance. 
Speak candidly to the medical attendant 
when in doubt as to your duty. A nurse 
with three years' hospital experience 
knows some things which a doctor with- 
out such hospital experience lacks. A 
wise physician will accept suggestions 
from some kind old granny whose hair 
has been whitened and whose judgment 
has been rendered acute by life-long ob- 
servation. Anyway, a doctor who would 
take oflFence at an inquiry seeking infor- 
mation for the good of the patient should 
become an osteopath or a chiropodist; 
he would still be called *'doctor," with 
his potency for harm minimized. Your 
relationship to the help in the family is 
another matter of much importance. 
Servants are prone to complain of the 
additional labor consequent upon sick- 
ness in the family, and they seem to 
have a particular aversion to trained 
nurses. The preparation of the sick 



room dietary by the nurse (and she 
alone should prepare it) necessarily re- 
quires time and interferance with the 
daily routine in the kitchen; other de- 
partments of the household economy are 
likewise interfered with. A good nurse 
should be able to adapt herself to her 
surroundings. Tact and policy in this re- 
gard are invaluable possessions. Do not 
be above assisting the servant in this 
additional labor where occasion calls for 
it Her good will is worth cultivating. 
Your presence in the household will be 
rendered happier by it. Menial work 
when performed for the sick glorifies the 
deed and renders it akin to the divine. 
In your deportment be gentle, yet 
strong ; amiable, yet determined ; sympa- 
thetic, but not overzealous in its expres- 
sion; discreetly confidential, but never 
descending to gossip; attentive to your 
patient and considerate toward all, if 
you desire to find honor in your profes- 
sion. 

A word to you who employ nurses and 
my task will be done. A trained nurse 
of to-day, by virtue of her degree, is a 
woman of education and should be re- 
fined in manner. Your duty will be to 
receive her hospitably as you would an 
honored guest. Being very human she 
will require regular meals, a certain 
number of hours of sleep and outdoor 
exercise properly to perform her duties. 
Guard her against annoyances, and by 
action and words show your appreciation 
of her eflForts. Consider yourself, not- 
withstanding her presence, master or 
mistress of your home. The privileges 
of the sick room are yours, unless for 
good reasons the physician has ordered 
otherwise. The nurse is under your su- 
pervision in everything excepting the ad- 
ministration of medicines and personal 
supervision of the patient. Modern 



RESPONSIBILITIES OF YOUR VOCATION 



143 



nursing requires on the part of the nurse 
a knowledge which you do not possess. 
The various modes of administering 
medicine, their effects, recognition of 
symptoms, the use of instruments of 
precision, the prevention of contagion, 
the keeping of a record of everything 
pertaining to the patient during the in- 
terim of the doctor's visit This last 
mentioned duty is of invaluable aid to 
him in his treatment of the case. The 
pecuniary reward received by the nurse 
in the care of a dangerous case of illness 
is inadequate. She gives not only her in- 
telligence, nervous force, sympathy, but 
vitality as well. The true nurse finds her 
reward in her ability to lull pain by ease, 
to convert wakefulness into peaceful 



slumber, and to quench the fire of fever, 
and when reason asserts its power and 
the eyes beam with brightness and the 
tongue speaks the heart's gratitude, hai- 
bingers of returning health, the nurse's 
heart beats with joy, for that which she 
has accomplished is beyond price. 

Young ladies of the graduating class 
we bid you God-speed. You are now 
mistresses of your own destiny. Go 
forth into the world with the confidence 
commensurate with your ability. Ren- 
der your calling a synonym for all that 
is noble in woman's work, ever bearing 
with you that compassionate humility 
which led Mary Magdalen to wash the 
feet of our Saviour. 



Michigan. 



The Michigan State Nurses' Association 
held its sixth annual meeting at the Masonic 
Temple, Port Huron, June 28, 29 and 30. The 
meeting was called to order by the president, 
Mrs. G. O. Switzer. Rev. J. P. McManus 
delivered the invocation and Dr. A. H. Cote, 
acting for Mayor J. J. Bell, gave the visiting 
nurses a most cordial welcome. Response by 
Miss Fantine Pemberton. The remainder of 
the afternoon was devoted to the address of 
the president, the reports of the officers and 
chairman of committees, closing with a drill 
in parliamentary law by Mrs. Emma Fox, of 
Detroit 

In the evening Miss Jane Delano, of Wash- 
ington, gave an address on "Red Cross and 
Army Nursing," following which an informal 
reception was given. Wednesday morning 
was taken up with a parliamentary law drill, 
the report of Miss Sarah Sly, delegate to the 
meeting of the Nurses' Associated Alumnae 
of the United States, and the reports of the 
delegate to the State Federation of Woman's 
Clubs and on State Registration, given by 
Miss Elizabeth Flaws. 

After these reports the work was divided 
into two sections, one for the superintendents 
of training schools and the other for private 
duty nurses. Before each section very inter- 
esting papers were read. In the afternoon 



a boat ride was enjoyed by all at which a 
question box was conducted for each section. 
Wednesday evening Dr. Caroline Hedger, of 
Chicago, gave an address on "Social Hygiene." 
Thursday the meeting closed after the elec- 
tion of the following officers: President, 
Mrs. Ralph Apted, Grand Rapids; first-vice 
president, Mrs. G. O. Switzer Ludington; sec- 
ond-vice president, Mrs. R. G. Wheeler, Port 
Huron; recording secretary, Elizabeth Green- 
er, Muskegon; corresponding secretary, Fan- 
tine Pemberton, Ann Arbor; treasurer, Mrs. 
M. S. Foy, Battle Creek; chairman of com- 
mittees. Ways and Means, Elizabeth Parker, 
Lansing; Credentials, Mary Kurfess, Jack- 
son; Nominating, Agnes Deans, Detroit; 
Printing, Charlotte Dancy, Battle Creek; Ar- 
rangements, Margaret Moore, Jackson; 
councillor, Isabel Mclsaac, Benton Harbor. 
The meeting of 191 1 is to be held in Jack- 
son. 



Nichols Memorial Training School held 
their annual meeting at the hospital on July 
25. Business matters were discussed and new 
officers elected for the coming year. Presi- 
dent, Mrs. Edward Hoyt; vice-president. 
Miss Lula Barker; secretary. Miss Lucy 
Patterson; treasurer. Miss S. A. Gourlay. 



^ partial Solution of ttie 9tot)lent of ^roViiDins 
for ttie finxainQ of people of 2.tmtteti iEean^ * 



FRANCES H. BESCHERER. 



'TT^HE question of providing skilled 
-*- nursing for the moderate wage 
earner is one that has for some time 
past held the interest of the medical and 
nursing profession. Various have been 
the methods suggested for meeting this 
need, among them a sliding scale of fees 
for nurses and organization for each 
city or town which shall engage gradu- 
ate nurses at full pay and "sublet'* them 
to patients at a low rate, making up the 
deficit by popular subscription; sending 
out pupil nurses from hospitals in their 
second or third year; the conducting of 
short term schools, where women are 
given large doses of theory and small 
ones of practice for three to six months 
and then turned loose on a long-suffer- 
ing public as "nurses," etc., etc. All of 
these methods have been tried with more 
or less success each year. Meanwhile 
the hospital training schools turn out 
hundreds of splendidly equipped nurses, 
who, when one considers their expensive 
education, are perfectly justified in 
charging prices which only the wealthy 
can pay. The supply, if one can believe 
the statements of the registries, more 
than equals the demand. But the middle 
class ! 

The American Hospital Association, 
of which I am proud to be a member 
through its Training School Committee, 
has recommended a most admirable cur- 
riculum for the edification of the hos- 
pital training schools, but recommends 
that the question of the training of 



pupils for moderate income patients be 
thoroughly investigated and a report 
made next year. At a meeting of the 
committee a year ago the Albany Guild 
for the Care of the Sick was asked to 
present their method of preparing pupils 
to help in meeting the need in Albany. 
We feel greatly honored by the invita- 
tion to meet the members of this asso- 
ciation in a discussion of this subject. 
The Guild for the Care of the Sick grew 
out of an organization known as the 
Fruit and Flower Mission, which early 
in its existence recognized the need of 
administering to the physical needs of 
its sick poor. For several years, beside 
a small staflF of graduate nurses, a staff 
of so-called "domestic nurses, or attend- 
ants," were employed to assist in the care 
of those patients needing more than a 
daily visit. They were paid only for 
their days of work, being at liberty to 
accept other employment between cases. 
It can be readily understood that this 
was not a very satisfactory arrangement, 
as the guild must stand sponsor for all 
the nursing, be it good, bad or in- 
different. But the experiment proved 
that the need for continuous service ex- 
isted, and that the work had the support 
and co-operation of physicians, so the 
training school for high-grade domestic 
nurses was organized. A small number 
of young women who were reconimende 1 
by physicians for the work were engaged 
for a course of two years and six months 
three months of this being a probationary 



•Read at the meetlnfir ot the New England Society for the Education of 'Nurses. 



A PARTIAL SOLUTION OF THE PROBLEM 



145 



term. Their theoretical work con- 
sists of a weekly recitation in anatomy, 
physiology and hygiene and in nursing, 
using the text books found in any hos- 
pital training school, and a course of lec- 
tures by leading physicians of the city. 
A course in invalid cookery is given 'by a 
graduate dietetian, who is in charge of 
the guild's diet kitchen. If the pupil 
lives in town her salary begins at $io per 
month, increasing gradually to $20 at the 
end of the term. If not, she is paid $7 
per month, the guild providing lodging 
and two meals a day, the pupil providing 
her own lunch, and the increase is to $18 
per month. At the end of probation the 
pupil, if she is to remain, signs a con- 
tract, which calls for a continuous serv- 
ice for the remainder of the term, and 
stipulates that the fees charged for serv- 
ices after receiving her certificate shall be 
$16 per week for the first year of satis- 
factory work, after which $18 may be 
charged. The practical work begins at 
once. The pupil accompanies one of the 
graduate nurses on her pound of visits 
for the first few days only to observe. 
Then she is supplied with a bag equipped 
with the necessary dressings, solutions 
and instruments, and is permitted to as- 
sist the nurse in her work. She is taught 
to give baths, to make beds, to give ene- 
mata and douches, to catheterize, irriga- 
tions of bladder and colon, change bed 
and body clothing, the many little things 
which make for a patient's comfort. Per- 
haps one of the most important things 
learned in these visits to various homes 
is tact, for it requires a vast amount 
of that virtue to deal with the sick in 
their homes, to overcome the prejudices 
not only of the invalid, but also of his 
family. At the City Free Dispensary 
she is taught minor surgery, the making 
of bandages, dressings and solutions and 



the sterilization of instruments. Under 
the supervision of the graduate she assists 
the eye and ear, nose and throat special- 
ists in their examination and treatment. 
When she has been under instruction for 
some time she is sent alone to a patient 
to put in practice the teaching of the past 
few days, though only to a case requir- 
ing only such care as she has learned to 
give. This patient is visited later in the 
day by a graduate for supervision of the 
work done. This is continued through- 
out her training, though, of course, the 
following-up process does not take place 
every day as she advances. When the 
pupil has been thought capable of being 
placed on a case arrangements are made 
by the head nurse regarding charges, 
hours off duty, etc., and the pupil is vis- 
ited frequently by the head nurse or an- 
other graduate. During vacation of tu- 
berculosis nurse a pupil assists in the 
care of those taking the cure at home, 
especially in the care of bed patients and 
in the dispensary clinics. One whose 
term had nearly expired took the place 
of one of the graduates who was away 
on account of illness. When not on 
private duty a pupil always assists at 
any operation ; thus she gets her training 
in preparing for an operation in a private 
house, and is often sent in advance to 
prepare patient and room for operation. 
The care of the patient and her room 
comes under the pupil's care. She pre- 
pares and serves food, gives medication 
and treatments and keeps a record for the 
physician. Many times the care of the 
entire household devolves upon her. She 
cooks and serves meals for several mem- 
bers of the family, keeps the house in 
order, besides finding time for the prepa- 
ration of her work for the next class. 
One of the pupils cared for mother and 
babe and baked bread for a family of 



146 



THE TRAINED NURSE AND HOSPITAL REVIEW 



seven, because the mother was sure her 
family couldn't eat baker's bread. Thus 
it will be seen that a knowledge of house- 
keeping is an absolute necessity for a 
nurse for moderate income patients. 
Our pupils appreciate the lack of those 
appliances necessary for the proper care 
of the sick, as found in the homes of 
people of small means, and early in their 
career are taught to make use of what- 
ever is at hand. Besides the personal 
supervision of the pupils they are ex- 
pected to report on their work every 
evening either in person or by telephone. 
Questions are asked, advice given, etc., 
and on ckss days the nurses compare 
notes on their cases, each one learning 
from the other something which will help 
her in her work. Regarding the prices 
charged for this pupil nurse work it 
varies according to the need and financial 
condition of the patient and the amount 
of experience had by the nurse. The 
charges range from $5 to $13 per week. 
The variety of cases to which they are 
sent covers everything except contagious 
diseases and major surgery. We make 
the limit of service to any one patient 
three weeks, though this may be extended 
according to circumstances. As our aim 
is to give a variety of training, long 
chronic cases are avoided as much a.^ 
possible, though we do send pupils 
for a week or two. Actual experiment 
has proven that one pupil earned $87 
more than was paid for salary, board and 
lodging; on another the deficit was but 
$7, and the income of these pupils pays 
their expenses and that of one graduate 
nurse. Two weeks' vacation is given 
each year, and for each week of continu- 
ous service on a private case twenty-four 
hours off duty is given. Pupils living in 
boarding houses are provided with a set 
of rules regarding hours of rest, recrea- 



tion, etc. Those in their own homes are 
allowed more latitude. It is a dream 
of our future that we may have a cen- 
tral home for our pupils, where they can 
be supervised by a graduate nurse. 

The conferring of certificates occurs 
this month. Three nurses have success- 
fully passed an examination on medical, 
surgical and obstetrical nursing and 
physiology, the greater part of the ques- 
tions being taken from a file of those 
used in various States in their examina- 
tions for registered nurses. The general 
averages are 85, 86 and 87 per cent, re- 
spectively. Our certified nurses are in 
great demand, their services often being 
spoken for in advance before their course 
is finished. Rarely does any justifiable 
complaint of their work come to us, ana 
rejection of a pupil after probation for 
inefficiency seldom occurs. The course 
has been shortened to two years and 
three months. Now, with these facts and 
figures before you, does it not seem 
worth while that the work be tried in 
other cities where visiting nurse organi- 
zations exist? Many associations feel in 
many cases the need of more than can 
be given in a daily visit. Here is the op- 
portunity to give practical instruction 
to a pupil and to save money for the or- 
ganization. Many associations take- 
pupils from hospitals for training in visit- 
ing nursing. These pupils need super- 
vision while at work. Why not train 
young women along those lines who will 
be content to serve in the homes of the 
people of limited means for a limitei 
fee after finishing their course? Many 
applicants for hospital training are re- 
jected for no other reason than that of 
lack of the previous education which the 
hospital standard rightly demands. One 
of our hospitals has turned over to us the 
applications of several such women, and 



A PARTIAL SOLUTION OF THE PROBLEM 



147 



we have communicated with them, with 
the result that they have taken up our 
training and are most excellent pupils. 
A woman of common school education 
and possessed of sound common sense, 
with a rigid application to study and a de- 
sire to please her patients, will have no 
difficulty in pursuingher training. Wefind 
that as the pupil works with the graduate 
very little extra time is consumed in the 
practical work. The majority of -patients, 
so far from objecting to the presence of 
a pupil, appear to welcome the extra at- 
tention, and later on tell proudly of hav- 
ing the services of two nurses in their 
late illness. 



DISCUSSION : 

Dr. Patch — I would like to ask Miss 
Bescherer what becomes of these nurses after 
they leave instruction. 

Miss Bescherer — ^The nurses keep on with 
their work, charging the price that is allowed 
them, and are kept very busy by physician^, 
usually for whom they have worked, and we 
have never found that any pupil has exceeded 
the price for which she promised to work. 

Dr. Patch — ^Did I understand that they sign 
a contract agreeing not to exceed that price 
after graduation? 

Miss Bescherer — ^They sign a contract at 
the end of their probation, agreeing not to 
charge more than the rules call for. That 
price has been advanced during the last year. 
It was at first decided that the pupil could 
charge $i6 for the first three years, after 
that the amount could be raised to $i8; but 
they have done very good service, and so it 
was decided a month or two ago to make 
the charge $i8 after the first year of satisfac- 
tory service. 

Mrs. Codman — I should like to ask if it 
pays its way? 

Miss Bescherer — You mean for the organi- 
zation? 

Mrs. Codman — Yes — ^all the training; is the 
training entirely paid for by the money that 
comes in? 

Miss Bescherer — ^Yes, because it pays the 
pupil nurses' salaries, and the expenses, board 



and lodging, their carfare, and the salary and 
carfares of the one graduate nurse — ^usually 
the highest salary — that is covered; that is, 
the salary of the head nurse is covered by 
that amount. 

Miss Dart — Do you think it is fair for 
these young women to encourage them when 
they take up this course? 

Miss Bescherer — ^We never encourage them 
to take it; we always ask if there is any rea- 
son why they cannot take a hospital training. 
We advise them to apply to the hospital, and 
if, after application to the hospital, she finds 
that she can't be admitted on probation, we 
then will accept her application. 

Dr. Hugh Cabot — After these nurses are 
graduated and are out about their work, how 
is the distinction drawn between what they 
shall do, and the nurses graduating from the 
hospital, except that they charge less? Don't 
they in practice do the same work for a 
smaller fee? 

Miss Bescherer — I think in very many 
cases they do the same work. It is only be- 
cause the people can't afford to pay, or think 
they can't afford to, that they employ one ot 
our nurses. It isn't always the people who 
can't pay — it is the people who think they 
can't. 

Dr. Cabot — I should think that would work 
to the disadvantage of the nurses who are 
rather more competent to take care of the 
sick. 

Miss Bescherer — If the patients want the 
graduate nurses, they have only to engage 
one, and as long as they engage a certified 
nurse, I don't think the graduate nurse has 
an3rthing to say. They all register at the 
same registries; they register as graduates, 
or they register as domestic nurses, an<3r 
when a domestic nurse is called for, our 
nurses and other domestic nurses are referred 
to the patients. 

Dr. Cabot — You don't find there is any ob- 
jection? 

Miss Bescherer — Yes, very many nurses do 
offer objection, but at the same time they 
won't take that same case for $i6 a week. 

Dr. Cushing— Doesn't this have an effect 
of letting into the nursing profession, on 
substantially the same terms, women of in- 
ferior quality, those that the hospitals will 
not take on account of lack of preliminary 



148 



THE TRAINED NURSE AND HOSPITAL REVIEW 



education; and at the end of that training 
all the difference is that they are supposed 
not to take more than $i8? Now, that doesn't 
help the man who gets $15 a week and has 
a wife and several children, but it lets into 
the nursing profession women of insufficient 
preliminary training, and there is very little 
reason to think that, if they get a chancj 
and get into a good family, they won't ask 
as much as anybody else, whereas, on the 
other hand, I think very many nurses will 
take $18 if it is explained to them by the 
physician that the family cannot pay more 
than $18; that many a nurse who can get $21 
or $25 will go for $18 out of a feeling of 
professional duty. I can hardly think that 
the plan proposed makes for the professional 
advantage of the graduate nurse. 

Miss Bescherer — That may be the case in 
other cities, not Albany; but we have it for 
a fact that Albany nurses have been asked 
and have refused to nurse for less than the 
regular rates. Tliat may not be the case in 
other cities; I don't think that it is. But 
that is the fact in Albany — ^thaft Albany 
nurses have refused to nurse for less than 
their regular rates. 

Miss — Have these Albany nurses, 

as a whole, refused to work for $18 a week? 

Miss Bescherer — I have been told so; I 
don't know that they have. This was be- 
fore the Guild began to train nurses, or when 
they had only one or two who had finished. 
That was told by an Albany nurse, that she 
had known Albany nurses to say they had 
rather take an entirely charitable case than 
to lower the prices. 



Dr. Gushing— I would like to ask how the 
poor are taken care of? In the event that a 
man is able to pay $16 or $18, of course that 
is all right, but I would like to know how the 
Albany people take care of the people who 
can only pay $8 or $10? 

Miss Bescherer — ^Well, while our nurses 
are in training, we will take cases from $5 to 
$12, depending on the amount of experience, 
required and also on the financial condition 
of the person, so that they are not entirely de- 
pendent on those nurses who have finished; 
and those pupil nurses are under constant 
supervision of the graduate nurses who visit 
them every day, if necessary. 

Dr. Gushing — How many pupils have you 
in your school who are available for that 
purpose ? 

Miss Bescherer — The number of pupils 1* 
eleven. This is only a partial solution, be- 
cause we have only eight who have finished 
their training. 

Dr. Gushing — ^That was the point I wanted 
to get at. This is a very partial solution. Of 
course in Albany you have hundreds of 
sick poor, and you only provide very limited 
service. 

Dr. Palmer — If it solves the question in 
part, it is only a question of extending the 
system in order to provide for the care of 
all. 

Dr. T should say it was unfair to 

say that they don't do enough, because, so 
far as I can see, they do more than any other 
place. 



Personal. 

Miss Ruth Deming, Superintendent of Lu by the Naturopathic Institute and Sanato- 
verne Hospital, Luverne, Minn., is spending a rium of Los Angeles, Gal., to take charge of 
few months in Europe. the mechanical department. 



Miss Fannie M. Brooks, formerly with the 
Epworth Hospital, South Bend, Ind., also a 
graduate of the Pennsylvania Orthopaedic In- 
stitute, Philadelphia, has been placed in charge 
of the Hydro-Therapy Department at the 
Hackley Hospital, Muskegon, Mich. 



Miss Emma E. Wilkerson, Wichita, Kan., 
a graduate of the Pennsylvania Orthopaedic 
Institute, Philadelphia, Pa., has been engaged 



Mr. W. B. Dalpe, a graduate of the Penn- 
sylvania Orthopaedic Institute, Philadelphia, 
Pa., has been engaged by the Southern State 
Hospital, Patton, Gal., to take charge of the 
mechanical department and instruct the nurses 
in training. 

Miss Florence Garhart will again do pri- 
vate nursing in Sioux Gity after having spent 
a year in Galifornia. She is a garduate of 
the Samaritan Hospital, class of 05. 




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practical 3r>mli&m in planning i^odpttals 



MEYER J. STURM, B.S., 
HoBpital Architect and Consultant. 



THE distinction between ideals which 
are practical ideas and ideas 
which are impractical ideals is so marked 
that I hardly need go into a precise 
definition of their difference. Neverthe- 
less, despite the wide line of demarca- 
tion between the two, there has been up 
to within very recent years little or no 
practical idealism in hospital planning. 
The causes for this are many and varied, 
but the principal one, and the one upon 
which I wish to lay most stress, is the 
fact that hitherto the question has been 
considered from a standpoint of ideals, 
or it was the fixed idea of an individual 
with ideals largely impractical. 

In a recent paper appearing in one of 
the hospital magazines Dr. C. P. Emer- 
son stated in reference to the planning of 
hospitals and the construction of these, 
that "with few exceptions there are no 
architects in this country who have 
planned over two hospitals." All of you 
who are connected with hospitals are far 
too busy to go into the subject closely 
enough and minutely enough (except to 
get such ideas as might redound to the 
welfare of your own institutions) to get 
at a comprehensive idea of what is 
needed in not only your institution but 
in all institutions. Such meetings as this 
are of inestimable value, but no great 
surgeon was ever trained and perfected 
in his work, nor could he be, by getting 
the consensus of opinion from papers 
and discussions. 

Physicians on the whole have had 
rather impracticable ideas, inasmuch as 



their opportunity for studying the hos- 
pital from its administrative and main- 
tenance point of view, has been rather 
limited. The busy physician and surgeon 
had, or took, no time to acquaint himsell 
with what he considered the minor de- 
tails of the general administrative re- 
quirements of such institutions. These 
very points are the ones which are so 
necessary in the planning of hospitals, as 
ultimately the entire planning of a hos- 
pital must resolve itself about the neces- 
sary details of administration. 

It remained, therefore, in the evolu- 
tion of this subject that the question had 
to be left to the working out of general 
ideas rather than to a carefully planned 
consummation of practical ideals ; or per- 
haps, with the aid of an architect, one or 
two men would work out what they con- 
sidered a comprehensive plan for their 
own immediate needs, regardless of fu- 
ture exigencies. This plan was usually 
carried out with a viewpoint of getting 
the ideas of a local and general architect 
and the committee to fulfill the require- 
ments for the ordinary hospital. The 
fact that in this particular work, vital in 
its minutest detail, was needed the ser- 
vices of a specialist with a broad knowl- 
edge gained from the close study of an 
experience in this one field, has only in 
the last few years 'been recognized. 

The great question to be considered is 
that a hospital is a "living thing" which 
must be supple as well as graceful ; that 
it must be a means to an end rather than 
the end. The study of this problem too 



*Read (before tlie Canaxlls.n Hospital A8soci<a;tion. 
AU rlfirhtfl reeeirved by Mr. Sturm. 



Con'bributed to Thi Tbainbd Nurbi. 



PRACTICAL IDEALISM IN PLANNING HOSPITALS 



151 



often resolves itself in the one object of 
making the hospital a climax. This is 
diametrically opposed to what should be 
the case. Peculiarly, and this needs seri- 
ous thought, those who are building a 
hospital are not the final arbiters of the 
ultimate size to which this hospital shall 
attain. This is where the practical ideal- 
ism of most men connected with hos- 



necessity. They give no thought what- 
ever to the fact that when their institu- 
tion is full and they are running to 
their utmost capacity at all times, with 
more patients clamoring for admittance, 
or when the staff physicians and sur- 
geons, unable for lack of room to place 
their private patients in this hospital, will 
doubtless take them elsewhere, that this 



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*LOCAT10M ■ or Ho«PtTAI.- BkOtt* - 




A PLAN SHOWING THE ULTIMATE OF A HOSPITAL, THE FIRST UNIT OF WHICH 

IS SHOWN DEVELOPED IN FIGURE 3. 

(All of the oM (bulldlnETs will be removed upon the completion of the hospital.) 



pitals falls far short. They have rigidly 
fixed ideas that their hospital shall not 
contain more than just so many beds as 
its ultimate capacity. They give no 
thought to the growth of towns; they 
give no thought to the fact that people 
are becoming more and more educated to 
the hospital idea, and that the hospital is 
no longer a necessary evil, but a blessed 



condition gives birth to a mushroom 
growth of badly planned and poorly con- 
structed hospitals, a menace and a detri- 
ment to any growing community. 

It is this phase of the problem where 
a man's ideals should go beyond what 
this generation requires, and to prepare 
for the future of the institution. To-day 
there are too many indiscriminate calls 



152 



THE TRAINED NURSE AND HOSPITAL REVIEW 



made upon men for funds to endow or 
support institutions more or less worthy, 
'but which, from sheer ignorance of nec- 
essary detail in their planning and ad- 
ministration, are maintained at an ap- 
pallingly disproportionate expense. It is 
plainly evident that one good hospital 
containing loo beds, planned with a view 
to future enlargement, maintained at a 
minimum of expense, which has every 
advantage for the physicians in the town 
in which it is located, for the training of 
its nurses and the general care of its pa- 
tients, could be run at considerably less 
expense, so far as the general main- 
tenance charge was considered, than four 
hospitals containing twenty-five beds 
each of the type to which I refer, or, for 
that matter, of almost any type. There is 
too much division of the general main- 
tenance for the taking care of these lOO 
patients referred to in the separate 
smaller institutions. 

This maintenance charge is, after all, 
the vital point to be considered. One 
cent per day per patient in a lOO-bed 
hospital means the interest per year on 
$7»300-00> and I might add that this is a 
perpetual mortgage, the principal of 
which can never be paid. Calculate, it 
you please, what a saving of five cents 
per day per capita means in such a hos- 
pital. The saving every year, for all 
time, of the interest on $36,500.00 which, 
if this interest were added to the amount 
involved, would in a very few years be 
sufficient to double the size of the insti- 
tution. In five years this amounts in in- 
terest alone to over $10,000.00, and in 
ten years principal and interest amounts 
to $60,000.00, and this on the saving of 
only five cents per day on 100 patients. 

In a recent issue of the "Hospital," 
published in London, appeared the fol- 
lowing: "There is nothing more distress- 



ing to a practical man acquainted with 
the possibilities of hospital administra- 
tion than the evidence which accumu- 
lates with telling force as inspections are 
made of many hospitals. The purchase 
of relatively imperfect or useless fittings, 
the adoption of exploded methods of ven- 
tilation, the extravagance almost every- 
where manifest with increasing force in 
hospital buildings, the omission of prac- 
tical details and facilities which recent 
plans too often display, and the multi- 
tude of other matters afford melancholy 
evidence to the expert that something is 
wrong somewhere. 

It is dangerous and immensely costly 
to employ an architect to build a hos- 
pital who has no practical knowledge of 
its interior working and administration. 
Architects fail, as a rule, to grasp that 
the theory of hospital construction is a 
living thing. That is to say, it i$ never 
possible at any stage to say that a climax 
of excellence and completeness has been 
reached. The failure to appreciate this 
fact has produced a number of striking 
failures, as represented by recent hos- 
pital buildings of importance. What art 
we to say of a man who spends hundreds 
of thousands of pounds and shows so lit- 
tle apprehension of the requirements of 
a great hospital that he places his opera- 
tion theatres in a position which compels 
every patient operated upon to be 
brought out into the open air, and possi- 
bly to traverse some distance in it for 
some minutes? How many deaths may 
result from this one failure to appreciate 
realities, without possibly the architect 
ever realizing the innumerable deaths 
which may be justly laid in large meas- 
ure at his door ?" 

This clearly defines the present situa- 
tion. Every hospital is a separate and 
distinct problem, and just as any profes- 



PRACTICAL IDEALISM IN PLANNING HOSPITALS. 



153 



sional man becomes invaluable in his 
field of endeavor as lie concentrates and 
specializes on one particular effort or line 
of work, so with the hospital architect 
it has become a fixed understanding that 
upon him devolves the necessity of mak- 
ing the theory of hospital construction a 



growing thing. The first principle — I 
might say, the first of the practical ideals 
attainable in the development of the idea 
— is the greatest amount of servicea- 
bility at the lowest cost consistent with a 
first class structure and a minimum of 
fixed and maintenance charge for the 



Proposed bLook pUn , 

tftnitbMiu. Ka*plt«t> Stratheena^ Albta., C«n. 



OrUnt&tion of bui: 




Sloch Fl'n •hawing units for vl-tlaajte plda. 



TbiB 


plan ahoWB the pra 


tical m 


ethad 


for mak 


ns P 


eparation fe 




mate plan for a h 


ospltal. 


the sharted po 




being the fl 




the admlnlstr 










:meiita, whl 




the suoceedlms 


units 


avallabl 


for 


padentH aL 




able 


saving 


tar 


the number of 


patlents1o.be 



"living thing." And therein lies the prac- 
tical idealism. 

I can only give you a brief outline of 
the possibilities of making the hospital 
just what it should be, to fulfill the re- 
quirement of having it a living and a 



maximum of work to be done. Unfor- 
tunately, up to a few years ago, hospitals 
were the outcome of ideas evolved direct 
or in a perpetuated state of something 
which had already been done. The ideas 
which had been worked in this scheme 



154 



THE TRAINED NURSE AND HOSPITAL REVIEW 



of things have not always been ideal, as 
some of them were either indifferent or 
wholly bad. 

I am not going into the subject of the 
relative size of hospitals nor their cost, 
except to say that there is much need for 
education along these lines. While I do 
not, under any circumstances whatever, 
advocate the expensive hospitals in any 
sense of the word, still there should be 
sufficient funds to carry on the work 
without the necessity of endeavoring to 
get complete and equipped buildings for 
less than the bare cost of construction 
should be for a first-class building. 

Because a hospital of large capacity, 
say 300 to 500 beds, can be built at a 
roughly estimated cost of $1,200.00 to 
$1,500.00 per bed, or even in some cases 
as low as $1,000.00 per bed, as has some- 
times been done, this does not necessarily 
mean that because a hospital contains ten 
beds or fifty beds or one hundred beds, 
that it should cost respectively $10,- 
000.00, $50,000.00 or $100,000.00. A 
hospital containing fifty beds could cost 
anywhere from $60,000.00 to $100,000.00 
without being in the least extravagant. 
There are a multitude of reasons for the 
variations in cost, such as the proportion 
of wards to rooms, size of these, economy 
of plan, the expansion of the first unit 
of construction wherein has been placed 



the service for the succeeding units, 
either in whole or in part; the present 
price of labor and material, the necessity 
of making such buildings absolutely fire- 
proof, the isolating of each floor from 
every other fkwr, of separating the dif- 
ferent departments in such manner that 
there is no confusion and that there will 
be a minimum of maintenance charge. 
The same operating department which 
would be needed in a fifty-bed hospital, 
practically the same amount of kitchen 
department and general working depart- 
ment, would be required in a lOO-bed 
hospital or a 200-bed hospital, and «o it 
might be stated for the other items of 
fixed expense in such buildings from 
foundation to roof. Moreover, half a 
hundred different plans could be made 
for any hospital, each having merit, but 
it is safe to say that but one or two of 
these would be practically ideal from 
every point of view, especially in the 
economy of construction and in the econ- 
omy of maintenance, the ease of handling, 
and the thousand minor details which go 
to make up the hospital building. 

In a hospital which is planned and 
built without embodying these practical 
ideas fully and minutely, all is confusion 
never ceasing in maintenance and service. 

84 La Salle street, Chicago, 111. 



Personal. 



In Hope Congregational Church, Worces- 
ter, Mass., June 28, 1910, Miss Margaret 
Hogg, Class *07, Elliot City Hospital, Keene, 
N. H., to Mr. Hall. 



Miss E. M. Shiels, former head nurse at 
the Hazleton (Pa.) Hospital, to Qaude Roth, 
a prominent attorney of Philadelphia, Pa. 



At Fort Worth, Texas, May 21, 1910, Miss Miss Maude Irene Strobel, former superin- 

Laura Bates, graduate of Atlanta, Ga., to Mr. tendent of Bryn Mawr (Pa.) Hospital, to 
Bettes. Dr. Harvey J. Howard, of New York, 



tE:t)e delation o! tfie Cratntng ^cfiool to tt)e 

f^ospttal Sefictt problem* 



CHARLOTTE A. A I KENS. 



THE hospital deficit trouble is prob- 
ably not so frequently met with 
in its acute form in Canada as in the 
United States, but it is far from being 
uncommon, and it is a problem which 
faces most hospitals at some time in 
their history. It is often preventable, 
but, judging by observation, not always 
so; for just as some children seem to 
be born with a predisposition to a cer- 
tain disease or weakness, so, many in- 
stitutions seem to begin with this un- 
fortunate predisposition to an annual 
deficit. The reasons for deficits differ, 
but they can probably be placed in two 
main classes : faulty planning and con- 
struction, and poor business manage- 
ment. A large number of deficits are, 
or seem to be, dlue to a mistake in the 
primary plans or policy of an inexperi- 
enced board of managers. The hospital 
itself comes as the result of a vision — • 
an ideal of service which comes to some 
rrian or woman. This vision comes of a 
desire to do something for those less 
fortunate, or to help the poor and needy 
in some practical way. Hence the build- 
ing is planned mainly to accommodate 
the poor, or with a very mucli larger 
proportion of beds for free patients than 
for private paying patients — ^very often 
with more accommodation for this class 



Explanatory Note. — The text for this paper 
wa^s »ent to the writer a few months ago by the 
Presiden-t of the Chicago Society of Superin- 
tendents of Training Schools for Nurses. It 
contained two questions: Why do most of our 
hospitals show a deficit at the end tyf the year? 
Can the nurses better conditions? The matter 
contained in 'this paper is substantially the 
same as the paper prepared for that society. 



than the needs of the community call 
for. Free beds are provided, but noth- 
ing tangible or adequate to support 
them, and the result is bound in the 
very nature of the plans to be a deficit — 
large or small. This mistake seems to 
be well-nigh universal, for I have seen 
it and heard of it in all parts of fihe 
country where I have visited. Usually 
this mistake is corrected in course of 
time, but the first few months very fre- 
quently show only too plainly the blun- 
der that has been made. The way to 
correct it is much longer in coming, 
and in the meantime the deficit occurs 
and often becomes chronic. 

A study of the per capita cost per day 
in a score or more of general hospitals 
devoted to free and paying patients in 
the last few years shows that the aver- 
age cost is somewhere between $1.50 a 
day and $2. In some cases it runs as 
high as $2.25 a day for each patient, 
though this latter figure is exceptional. 
When we consider the number of pa- 
tients cared for entirely free of charge, 
and the large number who pay less than 
cost, and also remember that endow- 
ments are long in coming, it is not dif- 
ficult to explain the reason why some 
hospitals have deficits. Mr. Louis R. 
Curtis, superintendent of St. Luke\ 
Hospital, Chicago, in discussing this 
question at the Chicago Convention of 
the American Hospital Association, 
says: **I venture to say that not more 
than one-half of the private patients in 
the average hospital pay the full cost of 



•Read at the Convention of the Canadian Hospital Association. 



TRAINING SCHOOL AND HOSPITAL DEFICIT 



157 



their care, much less add anything to 
the net income of the institution. It 
may be accepted as a maxim that no 
hospital can conduct a private patients* 
service without loss, where the lowest 
rate is less than would be charged in 
an hotel of a corresponding class." 

The remedies for deficits need to be 
studied with each individual hospital in 
view, but there are certain general prin- 
ciples which apply to a large number. 
The extension and improvement of the 
pay patient department, so that that de- 
partment will not only pay expenses but 
yield a surplus to be used for the sup- 
port of non -paying or partial paying 
patients is one of the remedies for defi- 
cits that is meeting with general favor 
and good results on this side the At- 
lantic. 

Some plan by which municipalities 
may be induced to pay to private hos- 
pital corporations the actual cost of the 
care of indigent patients instead of a 
fixed rate of five or seven dollars a 
week, which is now paid in so many 
places, will probably be arrived at some 
time. A better understanding between 
hospitals in a given city or territory, and 
a more businesslike policy of charging 
paying ward patients the average actual 
cost will also help in reducing the deficit. 
Other remedies will readily suggest 
themselves to those familiar with hos- 
pital problems. 

There is, however, a very definite 
relation between the training school 
and the size of the deficit, for the 
daily routine of a hospital affords 
large opportunities for waste. Prob- 
ably every school has spasmodic and 
periodic lectures or talks on the sin 
of wastefulness. These spasmodic ef- 
forts often seem to put a check on 
waste for a brief season, but no such 



methods alone will ever effectually con- 
trol the problem. In the small hospital 
the superintendent can usually keep a 
hand on the distribution of supplies and 
a watchful eye over their use ; but as an 
institution grows this becomes impossi- 
ble, and some definite system designed 
to prevent waste becomes necessary. 
Various systems have been devised. Any 
one who desires to establish such a 
system can easily obtain suggestions 
based on experience from other hos- 
pitals. Miss Lightbourne, trustee-in- 
charge of the Hospital of the Good 
Shepherd, Syracuse, a moderate-sized 
institution of about a hundred and 
twenty beds, has given permission to 
refer to the system in use in that hos- 
pital. Nothing in the line of special 
supplies for any ward or department is 
obtained without requisition on blanks 
piiovided for that purpose. These requi- 
sitions are filed, the cost is estimated in 
the office, and eaoh week or month the 
head nurse is informed of the amount 
and cost of the supplies she has or- 
dered. With the actual knowledge of 
what her ward has cost 0omes the in- 
centive to keep the cost down, and to 
improve the record month by month. 
Such a system properly managed will 
produce good results in any hospital. 
TV) know is to control. Real control is 
never secured except on a basis of ac- 
tual knowledge. Scolding the nurses, 
appealing to their consciences, a grudg- 
ing giving out of supplies that are really 
needful, or trying to make the one who 
asks feel guilty will utterly fail to check 
waste unless there is some method es- 
tablished by which each yard of gauze, 
each cake of soap, each catheter, each 
thermometer, each paper of pins, each 
piece of linen is recorded and charged 
to the account of somebody who is ac- 



158 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Qountable for its proper use. Without 
an account of soiled linen and clean 
linen going in and out of a ward or de- 
partment no effective check on waste or 
extravagant use of linen is possible, for 
nobbdy knows just how much was used 
or was necessary. 

As an illustration of the possibilities 
of economy that are in a hospital ward, 
I mention an experiment tried in Belle- 
vue Hospital a few years ago, about the 
time there was such an outcry in New 
York regarding hospital deficits, and 
when there was serious danger of some 
of the hospitals having to curtail their 
service for lack of funds. At that time 
Dr. Brannan, president of the Board of 
Trustees of Bellevue and Allied Hos- 
pitals, wrote an open letter, from which 
the following is quoted:. "The attention 
of the visiting surgeon of one of the 
divisions of Bellevue Hospital was called 
about a month ago to the large con- 
sumption of gauze in his wards, some 
2,100 yards having been used in the 
previous week. He at once made an 
investigation, with the result that the 
next week the amount of gauze con- 
sumed was only 1,100 yards, and during 
the week following that only 610 yards, 
although the service continued just as 
active and the patients were cared for 
fully as well as before." 

A great many hospitals are at a dis- 
advantage in this respect, because there 
are not permanent head nurses in each 
ward or department. The apparent sav- 
ing made by putting pupil nurses into 
executive positions is often more ap- 
parent than real, unless the pupil head 
nurse had' been well trained in the pro- 
motion of intelligent edonomy. In a 
ward or department of twenty patients 
a saving or waste of even five cents for 
each patient a day in the handling of 



the entire supplies used — light, food» 
drugs, dressings, utensils, linen, etc. — will 
make a difference of thirty dollars, a sum 
which would go far toward paying the 
salary of the head nurse. Without 
doubt much more than this amount is 
wasted day after day for lack of ex- 
perienced supervision in many hospitals. 
The periodic changing necessary when 
the head nurse is still in training, pre- 
cludes the possibility of the best results 
in many directions. The pupil nurse 
always lacks the authority of a perma- 
nent head nurse. Even if she is urged, 
she hesitates to use it, and the incentive 
which comes from a desire to "make 
good'* in a permanent position is also 
absent. 

The operating room nurse in a hos- 
pital with an active service can easily 
waste or save the amount of her salar> 
every month. The waste in the operat- 
ing room is, of course, not entirely un- 
der the control of the training schbol, 
but it is partially so. There seems to be 
a tremendous difference in the amounts 
of supplies used in different operating 
rooms doing the same amount and kind 
of wtork. An operating room nurse a 
few years ago undertook to secure from 
a number of hospitals figures showing 
the amounts of certain supplies used. She 
found that in rubber gloves the amount 
varied all the way from 12 pairs a month 
for 252 operations to 300 pairs for 162 
operations. In one hospital 80 towels 
is the average number used for an op- 
eration. While another )t>perating room 
shows but 16 towels used on an average 
for the same kind of operation. The 
extravagance in the use of linen in the 
operating room cannot, of course, all be 
charged to the nurses, but undoubtedly 
much of it can, and the head nurse can 
do a good deal to check it if she is so 



TRAINING SCHOOL AND HOSPITAL DEFICIT 



159 



inclined. The costly equipment of the 
modern operating room and general 
surroundings tends to extravagance, and 
the nurses often unwittingly and unin- 
telligently, rather than intentionally ac- 
quire the habit of lavish or extravagant 
use of linen and supplies. Gauze is so 
common they think it must be cheap; 
rubber gloves likewise. They know no 
mjore of the cost of ligature materials 
than an infant, so it is not surprising 
that when entrusted to handle such sup- 
plies they cut the sutures and ligatures 
half as long again as is necessary, and 
are blissfully unconscious as to the 
value of the ends which they sweep up 
after the operation is over. A system- 
atic course of lectures on hospital econ- 
omy, starting at the very beginning of 
a pupil nurse's course, and given peri- 
odically two or three times a year to the 
different classes, would help a good deal 
in securing intelligent econiomy and the 
co-operation of the majority in efforts 
to prevent waste. Ignorance as to the 
cost of supplies, as to how waste occurs, 
cvery-day general ignorance of values, 
and the lack of a feeling of responsi- 
bility on the part of internes, head 
nurses and pupil nurses, is responsible 
for much of the waste which we period- 
ically discuss and deplore. Ignorance 
is always costly, and especially is this 
true of hospital work. 

Some methods of checking waste 
which are in use in the Massachusetts 
General Hospital have been described 
by the present and former superintend- 
ent. It is stated that in the operating 
room a slip is made out after each op- 
eration and turned in to the proper au- 
thority, giving the name of the operator, 
number of sponges taken in to that op- 
eration, the number opened, the num- 
ber used, the amount of catgut opened 



and the amount used, the number of 
towels and various other details. With 
this information in hand it is easy to 
compare amounts used by different op- 
erators, and to check waste, because ac- 
curate facts are at hand to use. 

Two of the main sources of waste are 
surgical gauze and food supplies. The 
system of saving gauze and washing and 
resterilizing it for use you are probably 
familiar with. After the ad^option of 
that system it is stated by the superin- 
tendent that : *Tn the first eight months 
of 1904 we used over one hundred and 
forty miles of new gauze three feet wide. 
In the first eight months after the 
adoption of the system we used only 51 
miles," and a saving of $3,000 in those 
months was effected. 

Regarding the system of preventing 
waste of food supplies, an assistant su- 
perintendent says: "The tendency of 
most nurses is to put too much food on 
patients' trays, sometimes because they 
do not want to be bothered by serving 
more food if called for, or because they 
do not realize that sick people do not 
eat as much as healthy laborers. We 
try to have as many wards as possible 
visited at mealtimes by the dietitian, the 
assistant superintendents of nurses and 
by assistant resident physicians. Head 
nurses are, of course, expected to watch 
the serving carefully. The result is that 
meals are more attractively served and 
unnecessary waste is kept down." 

In that hospital also a systematic in- 
spection of the contents of scrap pails 
is made, which results in the discoverv 
of safety pins, rubber dam, knives, forks 
and spoons which, through the care- 
lessness of somebody, have found their 
way into the waste pail to be burned. 
We could all add to this list, I am sure. 
The plan of a systematic inspection of 



160 



THE TRAINED NURSE AND HOSPITAL REVIEW 



garbage is one that is not commonly 
followed, judging by experience and ob- 
servation; but the experience of this 
hospital shows that it pays well for the 
time it costs. If the scrap pails are all 
numbered it is easy to locate the head 
nurse whose business it is, or should be, 
to prevent waste. 

A good deal of misconception exists 
as to the actual cost of the training 
school, or of training each nurse, and, 
as a matter of fact, we have very little 
accurate knowledge of the cost. The 
Worcester City Hospital, a few years 
ago, engaged an auditing company to 
establish a system of accounting which 
would make it possible to tell exactly 
what it cost to operate the different de- 
partments. They found the cost to the 
hospital of each nurse per day was, in 
1908, $1.06, and $1.08 the year before, 
or about $1,165 ^or the three years' 
course. Whether this is about the aver- 
age cost in hospitals as a whole I do not 
know, but it costs more to train a nurse 
properly than it did ten years ago, and 
the probabilities are that the cost is not 
going to grow less. The training 
school that is properly housed, equipped, 
manned, organized and supervised costs 
something, and tTie training school 
which does not cost much in time, ef- 
fort, or money is not worth much. I 
. am fully convinced, however, that as 



our methods of instructing and super- 
vising nurses and systematizing our gen- 
eral work improve, as we gain more ac- 
curate knowledge of What our methods, 
whether good or bad, cost, we shall 
come to a realization that there is a 
very close relation between our training 
school and our training methods and 
the size of the annual deficit. As we 
grow in wisdom and knowledge we shall 
endeavor more earnestly to save from 
the scrap pails and the junk heap, in 
order that we may have more money to 
spend for paid instructors and' super- 
visors and general improvements. Thus 
far we have not seen fit to include in 
our curriculum a course in tact, nor one 
in practical methods of economy — 
though we readily concede that both of 
these subjects are of very great impor- 
tance in successful hospital management. 
Perhaps in the future we shall be wiser. 
We shall find out yet many secrets in 
the line of economy in the daily routine. 
We shall save on the one hand that we 
may have more money to spend for 
practical improvements on the other. 
We shall make it possible for every 
nurse superintendent to have a course 
in practical institutional management be- 
fore she assumes charge of a hospital 
or training school, and we shall turn 
out more economical, more widely intel- 
ligent nurses from our schools. 



The Doee of Codeine. 

Fraenkel {Munch. Med. Woch.) claims mum dose permissible is one and one-half 

that codeine must be given in larger doses grains and maximum daily dose is four and 

than is generally used in order that the full one-half grains. For children the daily dose 

effect may be obtained, as codeine is from ten nay be as follows: 

to twenty times less powerful than morphine. 4 years of age 1-6 grain. 

The proper dose should be two-thirds or three- 6 years of age 1-3 grain. 

fourths grain, and this amount may be given 8 years of age 2-3 grain 

three or four times a day without any evi- 12 years of age i 1-4 grain 

dence of habit formation. The single maxi- Meyer Brothers Druggist, July, 1910. 



Cije Sftnpottant ^art of tt)e finx^t in tt)e $re\)rn^ 
tton anti tl^reatment of ¥^ult)ot)astnttt{( 

in Ct)tltiten 

B. WALLACE HAMILTON, M. D., NEW YORK CITY. 

Physician to Children's CUnlc, Prtsbylerian Hospital Dispensary ; Clinical Assistant in Pediatrics, 

Vandeilbilt Cll-nlc. 



IT is conceded by all observers that no 
disease of children is more rapidly 
contagious, more obstinate to check, or 
more refractory to treatment than gono- 
coccus viilvo-vaginitis. The responsible 
role of the nurse in this dreaded disease 
is one of great importance, and the vari- 
ous modes of infection should be known 
to every well-trained nurse. 

No more forcible statement could be 
made than to mention that the average 
duration of these cases is several months 
and often years, during which time the 
child is a constant menace to all who 
come in contact with her. 

This inection in children is by no 
means limited to dispensary and hospital 
patients, nor even to children o the tene- 
ments, but may be met with in children 
living under ideal hygienic surroundings, 
where least expected. 

It is readily recognized in the recent 
case by the yellow or yellow-greenish 
creamy pus in and about the vulva. This 
discharge later becomes thin and mucus- 
like in character and much less in quan- 
tity. This mucus-like discharge may be- 
come so small in amount as not to stain 
the child's underclothing, but still may 
be highly contagious and continue so for 
a long period of time. 

The introduction of bacteriological ex- 
amination of secretions from the vagina 
of all little children as a routine measure 
before admission to any hospital, day 



nursery, foundling home or kindergarten 
has brought to light within recent years 
the surprising prevalence of this disease 
in children under ten years of age. 

MODE OF INFECl'ION. 

The various modes of infection of this 
highly contagious disease are almost num- 
berless. Almost every article entering into 
the equipment of the hospital, orphanage, 
asylum or other public institution, has 
been accused as the agent of infection. 

Cases occurring outside of institutions 
are generally infected by the mother, less 
often by the father, sister, brother or 
some other inmate of the house. Often 
the child has shared the bed of an in- 
fected adult, or ihas been bathed with the 
same sponge, towel or wash cloth. The 
mother's and nurse's fingers are often 
conveyers of the infection. 

In tracing a case of this rapid infection 
many investigators both in Germany and 
in this country have taken great pains to 
find the common source of contagion. 

Before going into the ways and means 
to combat this prevalent disease, it is 
well to enumerate in a practical way a 
few of the characteristics of its cause, 
i. e., the gonococcus. Experiments have 
shown that this organism is killed by 
dryness and by any temperature at)ove 
SO de. C, or 122 deg. F. Gonorrheal 
pus, which has been fully dried, con- 
tains no living germs; and on all bed 
linen, towels, etc., where drying took 



162 



THE TRAINED NURSE AND HOSPITAL REVIEW 



place slowly, germs lived but a few 
hours. On the other hand, the germs can 
live a great many hours (24 to 60) in 
warmth and moisture. Having these es- 
sential facts in mind, the necessity of re- 
garding all objects retaining any degree 
of dampness or warmth coming in con- 
tact with patients should be naturally re- 
garded as modes of infection. To men- 
tion a few of the more important factors, 
i. e., seats of water closets, bathtubs, 
towels, sponges, night clothes, clinical 
thermometers, diapers bed linen, and 
most important of all, the fingers of the 
nurse. 

In many hospitals where infected chil- 
dren are isolated special nurses are as- 
signed to them by day only, while the 
night nurse cares for uninfected cases as 
well as those infected. This latter mode 
of inection has been traced to many cases 
by Dr. Holt. In institutions where chil- 
dren sleep two or more in a bed, or are 
bathed in the same water, infection is 
not hard to trace. 

PROPHYLAXIS. 

Adtnission of Female Children — 
Parents desiring to admit children to in- 
stitutions frequently bathe the child be- 
fore applying. In this way a discharge 
may be overlooked. The diild may also 
have a discharge so slight in amount as 
to be impossible to note on visual ex- 
amination. All female children applying 
for admission to any institution should 
be placed in an isolation ward for a 
period of not less than three days, and 
at least two microscopical examinations 
of the vaginal secretion be negative be- 
fore she is placed with other children. 

Isolation — This must be prompt. The 
quarantine to extend to both nurses and 
attendants. Not only the day nurse, but 
the night nurse as well should he sep- 
arate. The duration of quarantine 



is a difficult problem. To be safe 
I should advise a complete quar- 
antine after all inflammation has 
subsided and all discharge ceased, 
to be continued for three weeks after a 
third negative bacteriological examina- 
tion of the secretions. 

Laundry — No sheets, bed linen, nap- 
kins, night clothes, or any clothing from 
infected children should go into the gen- 
eral laundry of the institution or home. 
These articles after removal should be 
thrown into a strong disinfectant solu- 
tion and should be washed separately. 

Bathing — ^The 'bathtub is a frequent 
mode of infection, therefore, during an 
epidemic tub bathing should be forbid- 
den. A spray bath on a marble or por- 
celain slab, with a proper angle foi 
drainage, is the ideal method of bathing, 
such as that recently installed in the 
Presbyterian Hospital, New York City. 
(See illustration.) 

Sponges should never be used in bath- 
ing. Wash cloths should not be used 
a1x>ut the buttocks and genitals, but only 
sterilized gauze or absorbent cotton, 
which can be destroyed by burning. 
Separate towels, frequently sterilized, are 
absolutely necessary. 

Nurse's Hands — The nurse's hands 
should be carefully washed in a disin- 
fectant solution after bathing or chang- 
ing napkins of each and every child 
Not only on account of the danger to 
herself but also because s^he may spread 
the disease in cleansing mouths or in 
handling feeding apparatus. 

DISTRICT NURSING 

In district nursing connected with the 
Vanderbilt Clinic we have, in the effort 
to instruct mothers regarding this dis- 
ease, given to each one a copy of the fol- 
lowing directions : 

I. This is a local contagious disease 



VULVOVAGlNlTtS IN CHILDREN 



16J 



which requires treatment until the phy- 
sician pronounces the child cured. It 
sometimes persists for many months. 

2. To avoid infecting other members 
of the family, always wash the hands 
thoroughly before and after treatment 
and after bathing of the parts. The dis- 
charge, if carried to the eyes, may cause 
blindness. 

3. The child should sleep alone. Be 
sure that no one uses any toilet articles, 
towels, napkins or wash cloths usetl by 
the patient. All napkins, sheets, under- 
clothing, towels and wash cloths should 
be either boiled or immersed in a solution 
of creolin (one tablespoonful to a gallon 
of water) before washing. Bathtubs, 



basins and everything else coming in con- 
tact with the patient should also be 
washed with this solution. 

4. It is advisable that all children with 
this disease should wear a napkin or pad, 
which should be changed daily. 

5. Parents are cautioned not to allo>v 
the child to mingle intimately with other 
little girls. She should not attend school 
or day nursery lest other children become 
infected. 

6. Cleanse the parts externally at least 
four times daily with a solution of borax 
or boric acid crystals, one teaspoonful to 
a pint of boiled water. 

125 West 76th street, New York. 



tHK babies bath room. 



llOWlNfi COMPLETE EyUTPMKNT, PRESBYTERIAN HOS- 
PITAL, NEW YORK CITY. 



jBturstng Snftttiom Btsfeacfe 



ANNIE E. HUTCHISON. 



/^THER things being equal, the care 
^^ of a patient suffering from a con- 
tagious disease, including, as it must, 
the hardships of a period of isolation 
and more or less personal risk, demands 
considerably more self-sacrifice on the 
part of the private nurse than the nurs- 
ing of the ordinary non-in factious cases. 
This, however, is not to be regarded as 
the chief reason wh^ so many private 
nurses refuse to take contagious cases, 
or accept them with visible reluctance. 
One reason, and an influential one, is 
that, notwithstanding the higher price 
per week that may be charged — and this 
is not always practicable — the nursing 
of a contagious disease may not infre- 
quently mean actual decrease of income 
to the nurse on account of the quaran- 
tine and the necessity of refusing other 
cases. As far as the writer's experience 
goes, most nurses accept personal risk 
with a ready cheerfulness fully in keep- 
ing with the character of that wonder- 
ful personage, seen chiefly in print and 
the imagination, the ideal nurse; yet in 
the ranks of those steadily engaged in 
private nursing very few slight financial 
considerations, because very few can 
afford to do so. A very consider- 
able number of nurses avoid con- 
tagious diseases, and feel justified in 
refusing them simply because of lack of 
experience in the nursing of such, their 
training in this regard having been 
chiefly or wholly theoretical. And wliere 
the hospital offers no opportunity for 
practical experience in this branch of 
nursing, the theoretical kno>vledge re- 
garding it that the graduate carries away 



with her very often leaves a good deal 
to be desired, probably because such in- 
struction was more or less perfunctory, 
or because as a pupil nurse the necessity 
for such knowledge appealed to her 
chiefly for examination purposes. Cer- 
tainly, some otherwise very excellent 
nurses possess astonishly hazy ideas re- 
garding the special care demanded in 
nursing some of the more common in- 
fectious diseases, such as measles, scar- 
let fever or diphtheria. 

Upon entering a private home to take 
charge of a patient suffering from a 
contagious disease the complete isola- 
tion of the patient is usually the first 
thing that the nurse must consider and 
arrange. In the case of a contagious 
disease the choice of room to be occu- 
pied by patient and nurse will frequently 
devolve upon the nurse, in which case 
she must be careful to choose the one 
best adapted to serve as a sick room 
and for the purposes of isolation. A 
room, or where possible, two rooms, 
should be chosen at the top of the 
house and in a situation as convenient 
as possible to the bathroom. Sometimes 
the whole top floor can be placed at the 
disposal of patient and nurse, and if the 
disease is of a malignant type this is by 
far the best arrangement to make, as 
the isolation in such a case can be much 
more perfectly carried out and the dan- 
ger of the infection spreading elsewhere 
greatly minimized. It will also prov«r 
a convenient and comfortable arrange- 
ment for the nurse, who, in this case, 
can have a room for herself near to that 
of the patient and shut up the remain- 



NURSING INFECTIOUS DISEASES 



165 



ing rooms. Prepare the room selected 
for the patient by removing carpet, cur- 
tains or other drapery, pictures, orna- 
ments and superfluous furniture, retain- 
ing in the sick room only as much plain 
furniture as will be required for actual 
use. Have the aspect of the sick 
room as pleasant as may be con 
sistent with the demands of the 
special case, always bearing in mind 
that the fewer superfluous articles 
retained the less work it will involve 
and the less danger of the infection 
spreading. If the patient is changed 
from one room to another it is usually 
advisable that the mattress and bed ling 
that have already been used and infecteil 
be taken for use in the isolation room, 
and the room that the patient leaves 
should be at once thoroughly fumigated. 
Before the nurse goes into quarantine 
she must not forget to select and have 
taken to the isolation quarters all the 
various articles that she knows she will 
require during the period of isolation. 
These will include bedding, clothing for 
patient, towels, disinfectants, soap, 
broom, dust pan, pail, whisk, a tub, for 
the purpose of soaking infected clothes, 
wash bowl, dishpan and all the dishes 
and utensils that she is likely to need. 
Where the nurse and patient occupy the 
whole of a flat, or where a conveniently 
situated bathroom can be set aside for 
their sole use, the bath tub can be util- 
ized for soaking the infected clothes, and 
is most convenient and satisfactory ; but 
where this is not the case a light zinc 
tub, which is easily handled, is well suit- 
ed for the purpose. .When the patient 
and nurse go into quarantine a sheet is 
Iiitng across the patient's door, so as to 
completely cover the doorway, and this 
is to be kept moist with a disinfectant 
solution, conveniently accomplished bs 



frequent sprinklings with an ordinary 
whisk dipped into the solution. When 
an upper flat is to be totally isolated 
from the rest of the house, the opening 
of the stairway should also be curtained 
off with sheets treated in the same way 
with disinfectant. Various disinfectant 
solutions are used for this purpose, a 
solution of carbolic acid being probably 
the one most favored. The carbolic so- 
lution is sometimes used of i in loo 
strength, or even weaker, but a 1-20 so- 
lution is very frequently preferred. A 
solution of formalin is favored by some. 
Formalin is an aqueous solution of for- 
maldehyde, containing 40 per cent for- 
maldehyde gas. It is a powerful disin- 
fectant, but if used very freely as a dis- 
infectant in the sick room its fume.s 
will prove too irritating to the mucous 
membranes, and it should, therefore, be 
used wath caution where one must inhale 
the vapor. While the doctor may give 
explicit orders regarding the disinfect- 
ant he prefers and the means to be em- 
ployed to prevent the spread of the in- 
fection, quite often, especially in the 
milder infectious cases, the nurse is ex- 
pected to use her own knowledge and 
take all necessary precautions without 
waiting for instructions. All infected 
clothing, such as sheets, pillow cases, pa- 
tient's gown, handkerchiefs, towels, etc., 
when removed should be at once im- 
mersed in a disinfectant solution, car- 
bolic acid 1-20, or a i per cent formal- 
dehyde solution being commonly used 
for this purpose. Where quarantine is 
confined to one room the tub contain- 
ing the disinfectant is placed in the pa- 
tient's rocm and soiled articles im- 
mersed as soon as removed. They should 
be allowed to remain in the disinfectant 
for at least four hours, and it is a com- 
mon practise to leave them over night or 



166 



THE TRAINED NURSE AND HOSPITAL REVIEW 



for a full twenty-four hours. Before 
sweeping the floor of the sick room it 
should be sprinkled with disinfectant so- 
lution to prevent the dust rising, and 
afterward dusted with cloths dampened 
with disinfectant. The sweepings should 
be rolled up in paper and sent down to 
be burned, and the cloths used should 
either be burned or soaked in disinfect- 
ant. All dishes used by the patient 
should be kept strictly for his own use, 
and are washed by the nurse and kept 
upstairs. Separate dishes are also kept 
for the nurse's own use and may be 
kept upstairs, or, in some circum- 
stances, may be sent down after being 
disinfected. In regard to the best places 
to keep the various utensils, dishes, med- 
icines, etc., the nurse will in each case 
decide for herself, according to the con- 
veniences afforded by the quarters at her 
disposal. When the bathroom can be 
used for this purpose all disinfectants 
and poisons are conveniently kept there, 
and medicines, glasses, etc., used for the 
patient may be kept on a small table 
in the sick room and covered with a 
clean towel. 

In caring for a patient suffering from 
an infectious disease the nurse must dis- 
infect all excreta, all utensils used, and 
be careful that nothing goes from the 
sick room without having been thor- 
oughly disinfected. All waste sent down 
to be burned should be rolled up in 
paper and dampened with disinfectant 
solution. The nurse must not mingle 
with the rest of the household, but 
should keep at some distance when 
necessary to hold communication with 
those downstairs who attend to her re- 
quirements. When the upper flat is shut 
off articles sent up may be left on the 
stairway to be afterward removed bv 
the nurse, and things that must be sent 



downstairs may, after disinfection, be 
placed on the stairway, to be removed 
when the nurse has left the hall. In all 
serious cases of an infectious nature it 
is necessary for the nurse to have an 
assistant share the quarantine with her, 
not necessarily another nurse in every 
case, but at least some reliable person 
who can assist or relieve her as re- 
quired. The nurse should, if possible, 
take a daily walk in the open air, for 
which she must wear outside clothing 
that has not been exposed to infection. 
She should always thoroughly wash and 
disinfect her hands each time after 
touching the patient or the bed, and 
before eating. A long gown is kept out- 
side the sick room for the doctor to put 
on before seeing the patient. The nurse 
must see that warm water, soap, towels 
and disinfectant solution are provided in 
the bathroom, or wherever the most de- 
sirable, so that the doctor can disinfect 
his hands before going downstairs. No 
visitors are allowed as long as quaran- 
tine lasts, unless, as sometimes happens 
in urgent circumstances, special permis- 
sion is granted by the physician, in 
which case the visitor must take all pre- 
cautions advised and submit to disinfec- 
tion as considered necessary by the 
doctor in individual circumstances. 

Free ventilation of the sick room is 
most important. It is the first requisite 
for disinfecting the room wliile occupied 
by patient. The nurse must contrive to 
secure free ventilation without allowing 
a direct draught upon the patient. 
Screens, if not on hand, may be readily 
improvised and should be used to protect 
bed where windows are so situated as to 
make this necessary. 

When permission is given to leave 
quarantine the nurse prepares for the 
complete disinfection of the patient, her- 



NURSING INFECTIOUS DISEASES 



167 



self, and the infected room or rooms. 
The patient is given a thorough bath of 
hot water and soap, hair being also 
washed, and this is followed by a bath 
of mercury bichlorid, 1-5000 (in certain 
cases a stronger solution may be or- 
dered), or other disinfectant bath as or- 
dered by the physician. After bath the 
patient is immediately wrapped in clean 
sheet or blanket and goes to another 
room, previously prepared, and provided 
with clean clothing. The nurse then pre- 
pares the sick room and any other in- 
fected apartments for furfiigation. All 
utensils, dishes, etc., are washed in disin- 
fectant solution. All infected linen is 
put to soak in a 1-20 acid carbolic solu- 
tion — mattress, pillows and blankets are 
removed and placed so that fumes of dis- 
infectant can find easy access to all parts. 
All drawers, closets or cupboards in 
room are left open, so that disinfecting 
fumes can enter, and everything arranged 
to facilitate disinfection. Cracks around 
doors and windows are sealed up to pre- 
vent escape of fumes. In some places a 
health officer is sent to attend the fumi- 
gation, but in places where this is not 
the case the nurse may have to look after 
it personally, or at least give advice and 
lend assistance. Rooms may be disin- 
fected with sulphur dioxide or formalde- 
hyde gas. The latter, if available, is the 
easier method and is frequently pre- 
ferred. Formaldehyde gas may be gen- 
erated from formalin tablets burned in a 
lamp for the purpose, or by the evapor- 
ation of formalin, four or five ounces be- 
ing allowed for 1,000 cubic feet of room 
space. Evaporation may be effected- by 
heating in vessel placed over a spirit 
lamp, or it is sometimes done by 
sprinkling the formalin over sheets 
hung up in the apartment. There is 
also an apparatus for generating the 



gas and forcing it into the room, and 
while this is to be preferred, it is very 
often not available. Formaldehyde gas 
does not tarnish or bleach articles, as 
sulphur fumes do. If sulphur dioxide 
gas is to be used for fumigating, sul- 
phur candles prepared for the purpose 
may be used, or the gas may be produced 
by the burning of ordinary sulphur, 
which has the advantage of being very 
cheap and easily procured. Four pounds 
of sulphur are allowed for every 1,000 
cubic feet of space, and it may be placed 
in a pan which is set upon several bricks 
in a tub containing enough water to cover 
them, the water being provided to avoid 
danger of fire from the burning sulphur. 
A liberal quantity of alcohol is then 
poured over the sulphur, and at the last 
moment before leaving the room a light- 
ed match is applied, great care being nec- 
essary to stand well back from pan and 
to avoid inhaling the sudden rise of 
fumes. After exit the door is sealed and 
room left for twenty-four hours. It is 
necessary to exercise great care in enter- 
ing a room after fumigation and in seal- 
ing the windows when preparing for 
fumigation, if none can be approadied 
and opened from the outside, one win- 
dow should be left in such a way as to 
be very readily opened. When entering 
to open the window, the person doing so 
should take the precaution of covering 
mouth and nose with a damp towel, and 
should pass in and out again as speedily 
as possible. Before leaving quarantine 
the nurse must thoroughly disinfect her- 
self, taking a disinfectant bath, washing 
hair in disinfectant solution and putting 
on clean clothes in another apartment. 
All her clothing and outfit exposed to in- 
fection are left behind, washable articles 
immersed in disinfectant solution and 
other things to b^ fumigated, 



X^efigottg in C!)emi«trp for fiuxit& 



MINNIE GOODNOW. 



Superlntsndent Bronson Hospital, Kalamazoo, Mich. 



Lesson II. 

Elements. There are in the world 
about two hundred and fifty thousand 
different substances. These, in varying 
forms and combinations, compose all the 
things of which we have any knowledge. 

When we trace these numerous sub- 
stances back to their origin, and break 
them up into their component parts, we 
find that there are but seventy-eight dif- 
ferent kinds of matter. There may be 
fewer than this, but we have not yet been 
able to ascertain. 

These seventy-eight are absolutely sim- 
ple substances, which cannot be divided 
into anything simpler. They arc called 
elements. 

An element is a ehetnically simple sub- 
stance, from ivhich nothing else can be 
extracted. 

Substances which contain more than 
one element are called compounds. A 
chemical compound is held together by 
a force )vhich we call chemical affinity. 

In the iron and sulphur experiment 
cited above, we had at first a simple me- 
chanical mixture, which upon heating be- 
came a chemical compound. The process 
was as follows: Each molecule of iron 
contains a fixed number of atoms; each 
molecule of sulphur likewise. The appli- 
cation of heat broke up the molecules 
of each su'bstance into their atoms. An 
exchange of atoms took place, and wo 
had formed a new set of molecules, each 
containing atoms of iron and atoms of 
sulphur, held together by chemical af- 
finity. These new molecules were iron 



sulphide, a substance quite unlike either 
of its original elements. 

The same thing happens whenever a 
chemical change takes place. Most of 
such changes are far more complicated 
than the example given. 

(We find, incidentally, that heat and 
moisture, or both, are necessary for the 
production of a chemical change.) 

The putting together of elements to 
form compounds is called synthesis. 
Note later the so-called "synthetic" com- 
pounds. 

The breaking up of compounds into 
the elements which compose them is 
called analysis. * 

There are, it has been said, seventy- 
eight elements. These have very different 
properties, both physical and chemical. 
For the sake of simplicity, we designate 
each element by an abbreviation, called a 
symbol, in some cases a single letter. A 
part of these abbreviations are from the 
Latin name of the element. The follow- 
ing is a list of some of the more common 
elements with their symbols: 

( It will be noted that some of the ele- 
ments are gases and a few are liquids, 
but. that most of them are solids.) 



♦ A chemical analysis of 'the human body re- 
sults In some interesting disclosures. We are 
told that the normal, healthy man who weighs 
one hundred and fifty pounds is the exact 
equivalent, chemically speaking, of one thou- 
sand hens' evrgs. He consists of over thirty- 
eight quarts of wa-ter, which makes up over 
half his we'ght; sixty lumps of sugar, twenty 
spoonfuls of salt, iron enough for seven spikes, 
two pounds of lime, thirty-flve hundred cubic 
feet of gas, oxygen, hydrogen and nitrogen; 
over twenty pounds of carbon, or enough for 
about ten thousand lead pencils; phosphorus 
enough for about eigh<t hundred thousand 
marches, and starch, sulphur, chloride of pot- 
ash and hydrochloric acid In lesser quantities. 



LESSONS IN CHEMISTRY 



169 



Al — Aluminum. 

Sb^Antimony (stibium). 

As — Arsenic. 

Bi — Bismuth. 

B — Boron. 

Br — Bromine. 

Ca — Calcium. 

C — Carbon. 

CI — Chlorine. 

Cu — Copper (cuprum). 

Au — Gold (aurum). 

H — Hydrogen. 

I — Iodine. 

Fe — Iron (ferrum). 

Pb— Lead (plumbum). 

Li — Lithium. 

Mg — Magnesium. 

Mn — Manganese. 

Hg — Mercury (hydrarg)Tuin). 

Ni — Nickel. 

N — Nitrogen. 

O — ^Oxygen. 

P — Phosphorus. 

Pt— Platinum. 

K — Potassium (kalium). 

Ag — Silver (argentum). 

Na — Sodium (natrium). 

Sr — Strontium. 

S — Sulphur. 

Sn — Tin (stannum). 

Zn — Zinc. 

Compounds are indicated by writing 
together the symbols of the elements 
which compose them. For example, com- 
mon salt — sodium chloride — is a com- 
pound of sodium and chlorine ; its for- 
mula is NaCl. This formula also tells us 
that the molecule of salt contains two 
atoms, one of each element. When a 
molecule contains more than one atom 
of a kind we write the symbol with a 
small figure below and to the right. For 
example, water is HgO, each molecule 
containing three atoms, two of hydrogen 
and one of oxygen. Ammonia is N H^,^ 
four atoms, one of nitrogen and three of 
hydrogen. 

Equations. An expression of the 
changes taking place when a chemical re- 
action occurs is called a chemical equa- 
tion. It is put into the usual form of 
e<luation and indicates an addition or ex- 
change. For example : 

Iron and sulphur make iron sulphide. 



Fe plus S equals FeS. 

Zinc and hydrochloric acid make zinc 
chloride and hydrogen. 

Zn plus HCl equals ZnCl plus H. 

In experiment No. 3, lesson i, the re- 
action is as follows: 

Sodium chloride (common salt) and 
silver nitrate make sodium nitrate and 
silver chloride.* 

NaCl plus AgN03=NaN08 plus 
AgCl. 

Laws Governing Chemical Reactions. 
Elements do not combine with one an- 
other in any indefinite or uncertain way, 
but always in exact proportion by weight, 
according to a fixed law. This is called 
the Lazv of Constant Proportions. 

Elements may, however, combine with 
each other in more than one proportion. 
These varying quantities are found to be 
exact multiples of the smallest amount 
that can enter into combination. The 
rule which governs this is called the Law 
of Multiple Proportions. 

(This law should be kept in mind par- 
ticularly in studying the organic com- 
pounds.) 

Law of the Conservation of Matter. 
The total weight of matter resulting 
from a combination or decomposition is 
always equal to the sum of the weights 
of all substances taking part in the re- 
action. 

This means that there is just so much 
matter in the universe, and that • no 
changes of any sort can aflFect the 
amount of each element. There is now 
in the world no more and no less iron 
than there was ten thousand years ago. 



♦ Nomenc!ature. The various compounds oc- 
curring with different proportions of the same 
elements are distinguished by names which 
suggest their composition. For example, CO is 
carbon monoxide, COi carbon dl-oxlde. HiO 
(water) is hydrogen monoxide, Had hydrogen 
peroxide. HgCl (calomel) is mercurous chlo- 
ride, HgClj (corrosive sublimate) Is mercuric 
chloride or bichloride of mercury. 



170 



THE TRAINED NURSE AND HOSPITAL REVIEW 



There is not a grain more or less of sil- 
ver on our planet than there was in the 
days of Noah ; neither is there more nor 
less oxygen or hydrogen. The number 
of compounds may be more or less, and 
the amount of each compound may be 
very different from what it was a year 
or a century ago, but the entire quantity 
of each element remains eternally the 
same. We cannot destroy any element, 
nor can we create the smallest portion 
of one. Compounds we may make or 
destroy, as we possess the requisite 



means or knowledge, but the final ele- 
ments are beyond man's control. 

To a casual observer this law seems 
not always to hold good; for example, 
in the burning of a candle matter seems 
actually to disappear. Exact experi- 
ments, however, prove that the gases 
which pass into the air in the process of 
combustion are, with the ash which is 
left, equal to the weight of the original 
substance plus the amount of oxygen 
consumed from the air in the process. 
(See Chemistry of Flame, Lesson VI.) 



^ xfeVu $otnt£( atiout tf)e Care of i^tck €t)tlt)ittn 



There is no cry in babyhood without 
significance. It is very often the nurse's 
business to find out the cause. In colic 
or griping abdominal pains the cry is 
passionate; in exhaustion, it is a weak, 
pitiful whine. Other conditions cause 
different cries. Study the character of 
the cry in babies in general. 



A binder which apparently fitted a 
baby properly before a meal may be too 
tight afterwar<l, and be the cause of dis- 
comfort. 

An obstruction in the nose which ne- 
cessitates a baby breathing through its 
mouth may interfere with nursing. 



In giving milk to young children much 
care is needed to prevent them from 
gulping it down too rapidly. In such 
cases it is apt to form into a tough in- 
digestible curd and cause rise of temper- 
ature and discomfort. 



In giving medicine to children, espe- 
cially those who have not been trained 



to prompt obedience, much difficulty is 
often encountered. Fortunately most 
drugs nowadays have their unpleasant- 
ness pretty well disguised. A little tactful 
coaxing will often work wonders. Bribery 
under such circumstances is forgivable, 
if anywhere. If it is very important that 
the child get the medicine, some novel 
scheme may be employed. One nurse 
made a story or play about every dose. 
The boy was given paper money under 
his pillow to pay for an imaginary soft 
drink, and the nurse played she was the 
druggist running a soft drink stand 
when she was fixing the medicine, ll 
worked like a charm. 

In another case the bribes were put ui> 
in the form of prize packages. They 
were cheap trifles or toys done up in 
fancy paper — one to be dra\^ii after each 
dose. The curiosity of the child to know 
what was in the prize package was quite 
sufficient to accomplish the desired end 
to the surprise of the parents, who ex- 
pected a prolonged fuss. 



A few goldfish in the sick room are 



CARE OF SICK CHILDREN 



171 



quite a source of interest in a tardy or 
prolonged convalescence. 

In feeding children or giving nourish- 
ment, vary the monotony as iimcli as pos- 
sible. Ingenuity will work wonders in 
getting a good meal taken in spile of a 
sluggish appetite. 



This may occur from the child being 
overtired or excited by talking, visitors, 
or games that were too exciting. It may 
occur because the diet was too stimu- 
lating, or the bowels sluggish, or the use 
of too many dainties. Indulgence in 
candy too freely has caused restlessness 
and intense nervousness even in adult 



GRADUATING CLASS, I9IO, WHITE HOSPITAL, RAVENNA, OlliO. 



For the removal of eczema crusts from 
the head a poultice of common laundry 
starch, made quite stiff and applied quite 
warm, will often effect the desired result 
in twelve to twenty-four hours. 

It frequently happens that nervous ir- 
ritability increases during convalescence. 



patients. The strength of a child is not 
easy to estimate, and it is better to prac- 
tice great moderation in the time allowed 
for sitting up till it is safe. After ton- 
silitis, though, it is often regarded as a 
minor illness. There is great prostration 
of strength, though the illness lasts but 
a few days. 



(jEtrttortallP ^peafeins 



The Coming Hospital Convention 

There is but one hospital convention 
each year in the United States. There- 
fore if you miss it, you have to wait a 
whole year before getting a chance to 
get in touch with hospital workers from 
near and far, and profiting by the in- 
spiration possible only through contact 
with the best workers in the. hospital 
field. This year the American Hospital 
Association meets in St. Louis, Mo., 
September 20-23. It is the first time 
the convention has gone to the South- 
west, that rapidly growing section of 
this country that opens up such im- 
mense possibilities along the line of hos- 
pital development. 

There are a lot of reasons which 
might be given why, if you are inter- 
ested in institutional work, you should 
make a great effort to attend this con- 
vention. Especially should those in the 
Central West and Southwest plan to at- 
tend. There are, as we remarked, many 
things which might be said about why 
you should go to conventions, but every- 
body has said them, so we will not take 
time to repeat what you know so well. 
''There is to be a round-table confer- 
ence of women hospital workers this 
year, we understand the first of its kind. 
If you are a woman hospital worker, 
you of course want to have this first dis- 
tinctly "woman's session" a great suc- 
cess. Go ready to take part in the con- 
ference. Bring to it any particularly 
"knotty" problem which you have on 
hand. 



Think over the subjects to be dis- 
cussed in the different papers and be 
ready to take some part, if it is no more 
than to ask a question or two. As a 
matter of fact, few things help along a 
discussion more than good practical ques- 
tions. Practice being a "walking inter- 
rogation point" at sessions and between 
times. That is one of the best ways of 
getting the most possible out of conven- 
tions. 

+ 

America's Registration Policy 

That the nurse registration policy as 
worked out in American laws has proven 
unpopular, not only to the large propor- 
tion of nurses, but to a still larger pro- 
portion of physicians and to the gen- 
eral public, needs no special argument. 
Many of those who were foremost in 
the work of securing some of the pres- 
ent registration laws frankly concede 
the fact, and admit their perplexity as to 
what to do next. They cannot point you 
to one law out of the twenty-three or 
twenty- four which we have that has 
worked satisfactorily nor fulfilled or even 
approached fulfillment of even the most 
moderate expectations of its promoters. 
The demand for less highly trained and 
cheaper nurses has increased each suc- 
ceeding year since registration laws have 
been in force, notably in New York 
State, where it has all along 'been most 
insistent. Correspondingly with the de- 
mand, short course and correspondence 
schools of nursing have increased. The 
advocates of present registration laws 



EDITORIALLY SPEAKING 



173 



have led, or tried to lead us to believe, 
that once such a law was passed the 
"graduates" of these classes of schools 
would hide their heads in shame and 
promptly seek some other field of labor. 

When forced to admit that not only 
the demand, but the supply of this class 
of nurses is steadily on the increase in 
registration States, one of the self-ap- 
pointed leaders consolingly reminds 
nurses that in spite of rigid registration 
laws in the medical profession quacks 
are very numerous. She conveniently 
forgets in making her comparison with 
the medical profession that the **quack" 
doctor must take the very same studies 
and pass the very same examinations as 
the physician who has reached the tof 
of the professional ladder; that whether 
he elects to be a "quack" or not, he must 
be registered before he is allowed to 
practice the art of healing. This is only 
an example of the superficial and mis- 
leading logic which has been used to con- 
fuse and delude nurses into an accept- 
ance of present registration policies. 

The whole system of registration of 
nurses, as we have it in America, is un- 
democratic and un-American. It was 
conceived in England, where the extreme 
social and class distinctions rejected by 
the founders of our republic <ti\\ hold 
sway. It provides for an aristocracy in 
nursing and ignores "the common peo- 
ple" who are the backbone of our repu'b- 
lic. The very system which we have, 
which had its birth in England, has been 
continuously rejected by that country for 
more than a score of years, though the 
recent bills which have been presented to 
the English legislature are an improve- 
ment in many respects over any regis- 
tration laws in existence in America. 

The principal of registration as a 



means to discrimination and protection 
is right, but no registration law which is 
designed to include less than one-tenth 
of those practicing the art will ever pro- 
tect the people. If it doesn't protect the 
public it is class legislation and unjustifi- 
able. 

It may seem as "the voice of one cry- 
ing in the wilderness" to insist and keep 
on insisting that every woman (or man) 
who practices the art of nursing for 
wages should be registered in some class, 
and should be required to know some- 
thing definite about nursing before being 
allowed to enter the nursing ranks to 
earn a living by service in the sickroom. 
Yet the experience of the past six or 
seven years with registration laws and 
profound impartial study given to the 
question by some of the brightest minds 
in the medical and nursing world, has 
clearly shown that no halfway, selfish, 
monopolistic measure will succeed. In 
the beginning three, or perhaps four, 
grades would seem to be necessary in 
order that no injustice be done to any 
class of practitioners. Later on three 
grades should be sufficient. 

To be sure the registering of three 
grades of nurses will upset the little plan 
conceived by the originators of the pres- 
ent registration system of tacking the 
R. N. to the name of the nurse who had 
registered, in lieu of an academic degree ; 
but the custom never had any justifica- 
tion. We would smile if we saw the 
letters R. T. after the name of a regis- 
tered school teacher, or R. H. after a reg- 
istered horseshoer. Yet there is precise- 
ly the same justification for these ap- 
pendages in the cases of teachers, bar- 
bers, plumbers and horseshoers as there 
is in the nursing field. 

In years to come we shall see more 



174 



The Trailed NukSE and hospital review 



clearly our stupidity in providing for 
registration and supervision of those 
nurses who least need supervision, while 
we have allowed the great wide nursing 
field to be invaded by any one and every 
one, however ignorant, who choses to don 
a uniform and style herself "nurse." 

+ 
How Par is the Nurse Responsible 

Much is being said and written at the 
present time regarding the so-called 
"black plague" and the "social evil." 
Nurses are being urged to join the ranks 
of reformers and assume the responsibil- 
ity, or at least share it, of educating the 
public in this matter. In fact one promi- 
nent nurse who is much interested in the 
subject has gone so far as to urge that 
each nurse take at least one young man 
of her acquaintance and instruct him on 
these lines. 

We are told that perhaps eighty per 
cent of the major gynecological opera- 
tions are due to gonorrheal infection, 
and that the great majority of these 
patients received the infection from their 
husbands. Whether or not the figures 
given are true we have no means of 
knowing, but granted that they are true, 
what can we do about it? Is the nurse 
to tell the patients whom she nurses, to 
what, or to whom their diseases are due ? 
And what will be the result when phe 
has told it? Or is she to tell every other 
woman that she is to suspect every man 
of venereal disease and refuse to marry 
any one she suspects? How much is 
likely to be accomplished by giving such 
information? How many women, if they 
really love the man, will believe him 
guilty? They are much more likely to. 
put the nurse in the list of meddling 
busybodies, and distrust her accordingly. 
Or if they do believe b'^r, how many will 



refuse to take the risk? We know of at 
least two trained nurses who have mar- 
ried patients whom they had nursed 
through a case of this same so-called 
"black plague." They took the risk with 
their eyes wide open because they loved, 
or thought they loved, the man. 

The nurse who enters on a campaign 
of reform of this kind has a pretty big 
contract on hand. Without question it 
is her duty to be intelligently informed 
about these communicable diseases in 
order that she may protect herself and 
others. How far 'beyond this she is re- 
sponsible for the abolition of the "social 
evil" more than wie of any other class of 
women is a pretty big question. After 
you have discussed its causes and results 
and given statistics, etc., you come back 
once more to the ever recurring question, 
what are we going to do about it? The 
subject is a sort of fad upon which many 
women have gone to extremes. They 
seem to see the "social evil" everywhere, 
to dream about it, to drag it into every 
conversation — sometimes by the very hair 
of the head — for it seemed to have no re- 
lation to the subject in hand. The nursing 
profession has a few of these "profes- 
sional agitators and promiscuous re- 
formers." They simply have to be re- 
forming something or somebody all the 
time. Reform is an obsession with them. 
A while ago it was the hospitals and 
training schools that had to be reformed. 
The small hospital must be wiped out. 
Then it was the almhouses. Now the 
abolition of the "social evil" is the one 
chief reform on hand. To say the 
least, it is a suflFiciently large contract 
to keep one busy for the next few years 
without touching one other single re- 
form. Would it not be better to entrust 
this work of reform to physicians who 



' EDITORIALLY SPEAKING 



175 



are in a much better position to deal 
with it? In the protection of children 
there might perhaps be occasions where 
the nurse could be helpful, but it is diffi- 
cult to see how in hospital or private 
work the nurse is situated to do much m 
this sort of reform without getting into 
ethical difficulties. She can, of course, 
prevent contagion spreading, and this she 
undoubtedly will do, but think twice be- 
fore assuming the role of reformer along 
the line of the "social evil." It is one 
that will easily lead nurses into seriou.i 
difficulties. There are few women more 
trying to meet than the woman who 
thinks she has a mission to abolish the 
"social evil." 4. 

The Civil Hospital* Manila 

We always welcome to our columns 
fair and intelligent criticism or discus- 
sion of any subject, for this is both in- 
teresting and profitable. But it is always 
a matter of regret when we are forced 
to bring before our readers an unpleas- 
ant controversy. Sometimes this is im- 
possible to avoid, as in the present in- 
stance when we feel that we must give 
some explanation regarding the letters in 
the "Letter Box" of this number which 
refer to the Civil Hospital at Manila. 

In the Spring of 1909, we received a 
newspaper from Manila which containe 1 
an article most severely criticizing the 
Civil Hospital and those in authority at 
that instituticn. The article was marked 
'•for publication," but as we did not 
know who had sent it, it was not pub- 
lished. A fhort time after we received a 
letter for publication, bearing upcn the 
same subject, which was published in our 
August, 1909, number. This letter was 
net, as Miss McCalmont so rashly con- 
cludes, and so injudiciously states, an 
anonymous letter, but came to this of- 



fice with the name and address of the 
writer, the only way a letter can be 
published in this magazine. After the 
publication of this letter we heard no 
more of the matter for some months, 
when we received from Miss McCalmont 
a most discourteous personal letter, ac- 
companied by a letter for publication, a 
statement for publication, presume ily, 
from the Bureau of Health, some photo- 
graphs and, incidentally, a subscription. 

Wishing to be perfectly fair, we ig- 
nored the discourtesy of the personal 
letter and published the statement and 
photographs in May, 19 10. The letter 
for publication was held pending an in- 
vestigation which we immediately set on 
foot. Owing to the distance ami other 
difficulties we have been some time in 
getting a report, but it is now in our 
possession, and is of such a nature that 
we most earnestly urge any nurse who 
is thinking of taking up the civil work 
in Manila to look into the matter most 
thoroughly before doing so. For she 
must remember it is no enviaWe posi- 
tion to be in a foreign country, seventeen 
thousand miles from home, perhaps with- 
out money, and at the mercy of enemies. 

Just previous to receiving our report 
we received the letter an 1 newspaper 
comment, which we publish side by sic'e 
with Miss McCalmont's letter in this 
number. The writer of the letter has 
been known to us for a number of years, 
Ln:\ can furnish other excellent testi- 
monials as to her standing. Her name is 
withheld for obvious reasons. The rec- 
ords of our investigations, the original of 
the newspaper comment, also other news- 
paper clippings, are to be found in our 
office. Again we urge nurses to inform 
themselves on this situation before de- 
ciding to take up the work. 



€1)0 ^ogpttal i^etite^ 



Important Points in Private Hospitals. 

An investigation has recently been made 
into the conditions existing in sixty private 
hospitals in and around New York City with a 
view to determining their provision for the 
safety and reasonable comfort and well-being 
of the hospital patients. The special com- 
mission appointed by the State Board of 
Charities to investigate has formulated several 
resolutions, the substance of which is as fol- 
lows : 

The board rules that it is necessary for 
safety that no patient shall be retained at pub 
lie expense in any ward of any hospital, 
wholly or partly under private control, unless 
suitable provision be made for each such pa- 
tient in four particulars which the resolutions 
plainly state. As this ruling of the board 
has been communicated to the different 
hosptals, the board expects that what inade- 
quate facilities were found to exist will be 
immediately remedied. In fact, in many cases 
the resolutions have been anticipated by the 
private hospitals in question and they are now 
busily engaged in making all necessary altera- 
tions and improvements. 

The patients must be kept either in a fire- 
proof building, or in a building whose fire 
protection facilities have been approved l)y 
the board. The buildings must be kept, in a 
sanitary condition, particularly as to plumbing, 
sinks, baths and other similar appliances. The 
board is especially emphatic as regards venti- 
lation and overcrowding in institutions that 
occupy buildings which were not originally 
erected for hospital purposes, and are thus not 
well adapted to the needs of the work con- 
ducted there. 

To assure proper ventilation, the board re- 
quires that patients should be kept in wards 
which provide at least 1,200 cubic feet of air 
for each bed or its occupant. More beds or 
occupants than thus provided for will not hv 
permitted unless free and adequate means of 
ventilation exist, approved by the board, and a 



special permit in writing is granted by the 
board, specifying the number of beds or 
amount of cubic air space, in no case less than 
800 cubic feet. That will be allowed only in 
extraordinary cases, when the permit is to be 
conspicuously posted in such wards. In ad- 
dition, the beds must be at least three feet in 
width and so arranged that the air under- 
neath shall have circulation and furnish ade- 
quate ventilation. The endeavor is to keep 
the space up to 1,200 cubic feet for each pa- 
tient, less than that being allowed only where 
superior means of ventilation exist. 



A New Idea in Hospital Construction. 

Probably some of the readers of T hk 
Trained Nuksk and Hospital Review have 
read of the newest development in sanitary 
house construction, an idea of Edison's, by 
which moulds are made for constructing the 
house of reinforced concrete, the moulds to 
be used over and over again, thus lessening 
the cost. As the moulds are made in sec- 
tions there is room for a limited variety in 
design. The moulded house lessens greatly 
the cost of a home, and experimen'ts are be- 
ing carried on by Edison, and a number of 
houses have been built in and around Balti- 
more and Washington, particularly with a 
view to improving the housing of wage 
earners. It appears also that the same iilea 
is to be utilized in hospital construction. 

The new State Hospital at Lima, O., will be 
unlike any other institution cf the kind in the 
United States and probably in the world, says 
Popular Mechanics. The building.s, all of 
which are rein f creed concrete, constitute a 
monolith. 

Forms were built for the walls, ceilings, 
floors and roof and the concrete was poured 
in, making all one solid piece. The whole 
comprises what is said to be the largest group 
of concrete buildings in the country. 

The arrangement is the result of a d.s're 
to isolate the different sections and at th.- 



THE Hospital review 



177 



same time have them strung together by con- 
necting links. Ahnost two years were con- 
sumed by the Building Commission and the 
architect in devising the plans. 

The buildings surround a rectangular court 
^50 by 500 feet. Each building, or gnup of 
buildings, radiating from this court, is known 
as a pavilion, and each pavilion has an indi- 
vidual court, used by the patients for exercis- 
ing and sitting in the open air. 

To the rear of the hospital is the power 
house, which will provide power, light, 
heat, and water supply. Ultimately detached 
cottages will surround the monolith. 

All coiKluits for electric wires an J tele- 
phones and all pipes for heating and water 
supply are built in the concrete. As far as 
possible wood has been eliminated, the hinges 
for doors and the anchors in window jambs 
for steel window guards being sunk into the 
concrete. 

All of the exterior walls have a brick 
veneer, an interesting feature in concrete cnn- 
struction. There is nothing in the structural 
parts of the mass of buildings that will dis- 
intergrate, and the whole is considered almost 
indestructible. 

+ 

The Hospital and Women Internes. 

At the present time an agitation which would 
appear at least to be based on justice, is going 
on in New York City with a view to inducing 
the boards of control of hospitals to cease dis- 
criminating against the women graduntcs in 
medicine as internes. Prominent in the cam- 
paign in behalf of the young women medical 
graduates are Drs. -Mary Hoffman Jones and 
Maude Glasgow. It h stated that there arc 
but two small hospitals in New York City 
where women are received and extended the 
same opportunities as men in completing their 
course of training and securing experience so 
desirable in the practice of medicine. In 
speaking on the injustice of the present situa- 
tion Dr. Glasgow says : 

"Take as one example Bellevue Hospital. 
Scores of our women medical graduates have 
made application there to take the examina- 
tion with the men. In the large new building 
that this institution is now erecting I under- 
stand that no provision has been made to take 
in women internes. 

"practically all of our hospitals are largely 



supported by women, who are among the most 
liberal contributors to this kind of philan- 
thropy. And, as I have stated, a large per- 
centage of the patients are of the same sex, 
so the ban placed upon the women physicians 
by the male boards appears to be all the more 
unreasonable/* 

"This barring of women physicians from 
the opportunity to gain practical experience 
in the work of our hospitals is terribly unjust. 
While the prejudice, not only among men, but 
among women as well, that has been directed 
against the women who have dared to enter 
the profession has been decreasing of late 
years, it has not reac+ied that altruistic stage 
for which we still hope. I do feel, however, 
that most of the men who are opposing us are 
not really conscious that they are not giving 
us fair treatment in this matter." 

"The patients in the city hospitals are, for 
the greater part, women and children. It docs 
not seem at all unreasonable that competent, 
although possibly young and more or less in- 
experieiKcd, women graduates of medical 
schools should be permitted to attend these 
kinds of cases. We at least ask that we be 
permitted to have equal opportunity with the 
men physicians." 

"Lhider the present conditions the only way 
that a girl graduate can get a chance to work 
in a dispensary is possibly through some in- 
fluence with a board member. To say the 
least, such a method is very far from satis- 
factory to the rank and file of the female 
graduates. All we ask is just an ordinary 
display of justice and no favoritism." 

That the agitation will be productive of 
good is probaible. If women are to practice 
medicine they should be allowed the fullest 
opportunity to increase their efficiency. In 
a letter relating to the interne question in 
general one of the most prominent medical 
men in the country advised a woman super- 
intendent of a hospital to try to secure a 
woman interne, adding that in his experience 
he had found them more faithful as a rule 
than men. 

One great difficulty lies in the fact that in 
most hospitals there is one certain section of 
the building fitted up for internes, but no pro- 
vision is made for separate toilet facilities, 
sitting rooms, etc., for the sexes. So it be- 
comes somewhat a problem in accommoda- 



178 



THE TRAINED NURSE AND HOSPITAL REVIEW 



tion at the very start. It does seem, how- 
ever, that one or more women internes might 
be accommodated with a little readjustment of 
existing conditions in the larger hospitals, and 
for the sake of humanity in general we hope 
the agitation will succeed. 



Mount Hope Hospital. 

Mount Hope Hospital, of Huntington, one 
of the most complete institutions in West Vir- 
ginia, was thrown open for public inspection 
with a delightfully arranged reception August 
I. Dr. R. E. Vickers, the official head, to- 
gether with Dr. H. H. C. Solter, and the 
superintendent, Mrs. Mary A. Morgan, have 
worked assiduously for months to equip a 
hospital so perfectly that it would attract the 
entire tri-State country. 

One of the many attractive features is the 
electric room on the first floor, which is in 
charge of Dr. H. C. Solter. In it are to be 
found a beautiful electric bath cabinet, vi- 
brator chair, X-rays, electors, static machine 
and every other contrivance suited to it. 

The laboratory, also on the first floor, is 
in charge of Dr. Pence, and here all chemical 
analysis is performed. 

The operating room on the third flcor is 
one that must be seen to be appreciated. 

The entire apartment is in white, heavily 
enameled and without a corner or resting place 
for dust. The floor is of white tile and 
everything else is steel and glass. The room 
is lighted by a number of large windows of 
Florentine glass. 

Illustrative of the complete equipment of 
the institution is the fact that in the back 
yard Mrs. Morgan, the superintendent, has 
installed a poultry house and runway, which 
contain a number of hens noted particularly 
for their laying ability. These furnish fresh 
eggs for the patients. 

The official staff is: Dr. R. E. Vickers, 
president ; Mrs. Mary Morgan, superintendent ; 
Miss Virginia Woods, head nurse. 



Pennsylvania Hospital. 

The Pennsylvania Hospital, Philadelphia, 
has issued its 159th annual report. This, the 
oldest of our American hospitals, dating back 
to 1751, is also one of our largest and most 
complete institutions. Besides the regular 



departments found in large, well-organized 
general hospitals, tt has also a department for 
the insane. In this latter department the high 
average of 39 per cent of recoveries arc re- 
ported for the year. It is said to be largely 
due to the admission of patients in the early 
stages of mental disease. The report of Dr. 
John B. Chapin, physician-in-chief and super- 
intendent of this department, is full of interest 
to all concerned in the welfare and care of 
such patients. Incidentally Dr. Chapin re- 
marks that the restoration of the general 
health is one of the most important factors 
in dealing with patients who are mentally de- 
ranged. He says "There are scientific instru- 
ments of precision which may record various 
interesting phenomena, but a Fairbank's scale 
is one that may properly have a place in the 
armamentarium of every hospital." 

+ 

Methodist Hospital. 

The Methodist Hospital, Philadelphia, will 
erect an additional building at a cost of 
$45,000. It will be called Bradley Hall, in 
honor of the president of the Board of Trus- 
tees, who has subscribed $35,000 for the needed 
improvements. The new building will provide 
quarters for the superintendent, internes and 
employes, besides accommodation for fifty ad- 
ditional patients, four large wards — two medi- 
cal and two surgical — each on two floors. At 
the end of each ward are new large screen 
enclosed porches, where the patients may be 
rolled in their beds to get the necessary fresh 
air and sunshine from a Southern exposure. 
On each of these floors is a large diet kitchen 
fitted with steam oven, with every modern 
convenience. A recovery room, a quiet room, 
a surgical dressing room, medical and surgical 
bathrooms and two lavatories. 

On the first or lower floor is to be the frjc 
dispensary and clinic. Two admitting rooms, 
for white and colored patients, then different 
rooms for medical, surgical, gyneological, and 
ear, eye, nose and tiiroat treatment. A phar- 
macy is also to be placed here for the dis- 
pensing of prescriptions. At one end of this 
lower floor is placed the plant which controls 
the electric fan for ventilating purposes. The 
air by this means is changed every four min- 
utes. 

Miss Ethel Smith is superintendent. 



THE HOSPITAL REVIEW. 



179 



Notes and News. 

The North American Sanitarium, for chil- 
dren suflfcring from surgical tuberculosis, has 
been opened at Atlantic City. It already has 
fifteen little patients, who are being treated 
free of charge. The location is considered 
ideal *for such work, and the sanitarium will 
combine the features of both a hospital and 
home. Miss Anna Van Valkenberg, a gradu- 
ate of Pennsylvania Hospital School for 
Nurses, is in charge. 



Mr. John Ross Robertson has erected a 
tuberculosis pavilion for the treatment of 
children suffering from tuberculosis. It has 
been presented to the Board of Managers of 
the Hospital for Sick Children, and is lo- 
cated on Toronto Island, near the Lakeside 
Home. 

The R. A. Kinloch Home for Nurses has 
been completed in connection with the Roper 
Hospital, Charlton, S. C. Before the earth- 
quake funds had been collected and set aside 
for this purpose, but the earthquake wrought 
such damage to the hospital property that it 
was removed to another site. The matter of 
the home for nurses was dropped for years, 
though the little fund in the bank kept slowly 
adding to itself. The present building is com- 
plete and well equipped, and is an altogether 
happy ending to a long delayed project. 



A $50,000 addition is to be made to the 
Nicholas Memorial Hospital at Battle Creek, 
Mich. The addition will give the hospital 
twenty additional rooms, an operati'.ig suite, 
laboratory and other much needed improve- 
ments. 



By the will of the late J. H. Huber, of 
Plana, 111., $50,000 is to be devoted to the 
erection of a charitable institution, and it is 
expected that a hospital for Pana will be de- 
cided on. 



Logansport, Ind., will receive $80,000 for 
the erection and maintenance of a hospital by 
the will of George E. Johnson, a former resi- 
dent. 



Hackley Hospital, Muskegon, Mich., treated 
650 patients last year. One hundred and 
twenty-five babies were born there. 



Quite a popular feature is the hydrotherapy 
department, that is heavily patronized both by 
persons receiving care in the institution and 
others paying regular visits there from without 
in order to gain the benefit of its electric light 
baths, Turkish and Russian baths, and other 
treatments. In all, 557 treatments were thus 
given, 274 to persons from outside. 

In the hospital laboratory there has been 
another heavy year of work. Physicians of 
the city and physicians from neighboring 
cities and villages send specimens there for 
examination. Besides all that was done for 
the regular patients, 179 special examinations 
were thus made. 

Hackley Hospital also pays the salary of the 
visiting nurse. In the latter work, a total of 
1,524 visits were made in the year. 

There are twenty nurses in training. Miss 
Elizabeth Greener is superintendent. 



Macon, Ga., is to spend about $600,000 in 
improving the Macon Hospital. A sanitary 
smoke-and-odor-proof kitchen is to be installed 
as one of the improvements. 



The New England Hospital for Women and 
Children will erect a new children's building. 



The Sisters of Charity will erect a new 
$100,000 building in Cincinnati, O., for the 
Good Samaritan Hospital. 



An addition, three stories in height, is to 
be made to the Episcopal Eye, Ear and Throat 
Hospital, at Washington, D. C. 



An unusual number of heat prostrations 
have been treated by Philadelphia hospitals 
this year. In several of the institutions the 
roof gardens are being utilized for this class 
of patients, while other institutions have pro- 
vided tents on the lawns. 



Miss Edith M. Maynard, Class '08, Elliot 
City Hospital, Keene, N. H., is convalescing 
from her very serious illness and is in Ver- 
mont 



Mrs. Margaret Grismore, a successful pri- 
vate nurse of Fort Worth, Texas, has gone 
to her home in Indiana for a much needed 
rest 



3fn tlje Craimng g>ct)ool 



CONDUCTED BY CHARLOTTE A. AIKENS 



Institutional Nursing 

{Continued from August.) 



In the city of Detroit this past year the 
librarians and the school teachers have made 
a dignified appeal to the city authorities for 
better wages. In each case the public was sur- 
prised to learn that the salary cnndition was 
as meagre as it was, and public sentiment 
backed up the workers in their request for 
an advance in remuneration. In the case of 
the librarians, the figures were strikingly 
small, and the raise was granted after little 
discussion. Our notions of ethics wnuld re- 
ceive a severe jolt if the head nurses stated 
their cases as frankly through the press as 
did some of these workers, but it is fair to 
suppose that if the public knew the facts, it 
would be quite as sympathetic with this class 
of workers as with these others mentioned. 
Many boards of managers would also, if the 
matter were put fairly and squarely before 
them by the superintendent, when the salary 
they have been accustomed to pay is inade- 
quate. The untrained cook in Detroit asks 
six dollars a week and her board and room 
in a private house, and gets it. The nurse, 
who has invested two or three of the best 
years of her life in training, and who has 
demonstrated her ability along executive lines, 
is surely worth twice that sum as a minimum 
wage. As she gains experience in admin- 
istrative responsibility, she is worth more 
than that. There is very great need for a 
readjustment of standards along this line, 
that will make head nurse positions in every 
hospital as well worth while in hospitals in 
general as they now are in numbers of cases. 
Another phase of institutional work which 
has received much less consideration on the 
part of hospital trustees than it deserves and 
which has a very real and practical bearing 
on the question of institutional nursing, is the 
degree of restriction in rcg*ard to Sunday 



work, which is enforced. I know of hospitals 
in which Sunday is made a "field day" in the 
operating room, in which clinics are held, and 
the work goes on just as it does on the other 
six days of the week — only more so. I have 
known of hospitals in which, to accommodate 
the doctor who was to lecture, a whole course 
of lectures was arranged for Sunday night. 
The latter condition is, I hope and believe, 
exceptional; the fnrn:cr unfortunately far 
from being as rare as it should be. If the 
rule is not to make Sunday one of the c' 
operating days, the custom of allowing any 
slight pretext of an excuse to form a reason 
for Sunday operations is all too common. 
They become more and more common unless 
ihe superiiiendenl and the board take a firm 
stand against any but actual emergency cases 
being operated on. The "Hoosier Schoolmas- 
iti" was not far astray when he remarked, 
"We're all selfish, accordin' to my tell," and 
the average physician, and especially the sur- 
geon, is no exception to the general rule. He 
has in many cases no hesitation at all in ask- 
ing that the nursing force be deprived of the 
Sunday rest which is their due, in order that 
he may accommodate hrs patient, who will 
thereby lose one day less from work or in 
order that he may have some medical or lay 
friend see him operate, who cannot be pres- 
ent the following day. These and equally 
trivial reasons are brought forward again 
and again as a reason for Sunday operations. 
When the chief surgeon of the hospital hap- 
pens to be a man of this type, it is not strange 
that institutional nursing is unpopular in that 
hospital, or that the superintendent is often 
heard to remark that "good head nurses are 
hard to find." No good head nurse will very 
long he content to remain where her right 
to rest and reasonable hours of work are not 



1 



y^ .^-^e-f-^^i^^ x2!^^C^^;^I^^A^^ 



I Pl>jrence, Italy. May '. 



182 



THE TRAINED NURSE AND HOSPITAL REVIEW 



recognized. No Czar of Russia is more mtr 
ciless nor exacting nor heedless of the rights 
of others than are some surgeons in regard 
to hospital workers, and where (here is a 
weak, yielding president and board, who can 
be so overawed by the presence of such a 
man on the staff thai ihey weakly yield to 
every demand, the problem of retaining cap- 
able head nurses in that insiiiution is exceed- 
ingly difficult 10 solve. Under the best of 
conditions, hospital work is hard, constant 
and nerve-racking. It is fascinating and has 
many delightful compensations, but Sundays 
and week days, Christmas and Easter, Thanks- 
giving and the Fourth of July, Summer and 
Winter, the work must go on without cessa- 
tion. The half-day on Sunday and half-day 
during the week are as necessary to the in- 
stitMional nurse as to any other class of the 
world's workers. To reach that idtal of jus- 
tice to hospital workers should be quite as 
much an aim of the managers as to reach a 
high grade of efficiency along other lines. It 
IS far from being an impossible ideal, given 
a superintendent and a board of trustees who 
honestly desire to have it, and who will con- 
stantly exert themselves to safeguard the 
rights of the resident huspilal \\oiking force. 
The other side of the question, as it re- 
lates especially to head nurses, will be dis- 
cussed in a future article. There is much to 



be said on the other side. But the fact re- 
mains that there is real need for reform in 
many institutions in relation to institutional 
nursing. We need a course of training in 
many laiijc hospitals thai will make it pos 
sible for the head nurse to gain a wider 
knowkdge of hospital management than that 
which comes to her naturally in her own de- 
partment. If this full, comprehensive course 
is given, a smaller salary is justifiable than 
where it is not. The minimum figures of $30 
or $35 a month are too small for a capable 
trained woman. Where faithful, efficient ser- 
vice is given, there should be a substantial 
advance till the maximum point is reached. 

I have known superintendents and trustees 
to let a capable operating room nurse go 
when ten or fifteen dollars a month added to 
her salary would have retained her valuable 
services tor years. It is easy to waste ten 
dollars each month in an operating room, and 
hundreds of ten dollars are wasted in the 
operating rooms of the country through in- 
efficient supervision in that department. It 
doesn't pay to carry economy to the point of 
underpaying capable hospital workers. A 
thorough ventilation of these phases of in- 
stitutional nursing by hospital superintendents 
and trustees would undoubtedly have a whole- 
some effect on conditions in general through- 
out the country. 



GRADUATINO CLASS, 1010, MEMORIAL HOSPlTALs JOHNSTOWN, N. T. 



$ook l&ebtetDs; 



Nursing in Diseases of the Eye, Ear, Nose 
and Throat, By the Committee on Nurses 
of the Manhattan Eye, Ear and Throat Hos- 
pital (J. Edward Giles, M;D., Arthur B. 
Duel, M.D., and Harman Smith, M.D., 
assisted by John R. Shannon, M.D., and John 
R. Page, M. D., with chapters by Herbert 
B. Wilcox, M. D., and Eugenia D. Ayers). 
For sale by the Lakeside Publishing Com- 
pany. Price $1.50. 

The authors have in this volume supplied 
a long- felt want, for much of the subject 
matter contained therein is usually to be 
found only in text books especially intended 
for physicians and medical students. To quote 
from the preface: "In looking about for a 
book on nursing which would serve as a 
text book for the nurses in the training 
school, we were unable to find one which 
seemed exactly adapted to our purpose. A 
practical difficulty in the preparation of such 
a book arises from the fact that the pre- 
liminary education of nurses varies so 
greatly. For this reason, certain things which 
are too advanced for some are elementary 
for others." Accordingly, the authors have 
begun at the beginning and have dwelt upon 
all the essentials of the work under con- 
sideration with most satisfactory results. 

The book' consists of five parts, each sub- 
divided into .several chapters, there being 
twenty-six chapters in all. Part first, con- 
sisting of ten chapters on general considera- 
tions of the principles of nursing, both ele- 
menar>' and with attention to these special 
lines of work, contains the following head- 
ings. I, Germ Theory of Diseases; 2, Anti- 
septic (Oxidizing Agents and Reducing 
Agents) ; 3, Disinfection of Rooms and 
Clothing; 4, Sterilization (of the Hands, of 
Dressings and Bandages, of Instruments) ; 
5, Preparation of Operating Rooms; 6, The 
Nurse's Duties at Operations; 7, The Nurse's 
Duties in Emergencies (Hemorrhago, 
Vomiting, Erysipelas, Drug Poisoning, etc.) ; 
S, Management of Troublesome Children; 9, 



The Ideal Nurse and Her Conduct in the 
Sick Room; 10, The Feeding and Care of 
Infants (Sleep, Temperature, the Bath, Con- 
vulsions, Infants* Diseases, etc.). 

Notably among these are the chapters on 
antiseptics, sterilization, the duties of the 
nurse at operations and in emergencies, the 
management of troublesome children, the ideal 
nurse, and the feeding of infants. The last 
mentioned topic is presented in a particularly 
lucid manner, for in a short space this im- 
portant ground is so well covered and so 
well expressed that the veriest novice may 
understand the principles intelligently. The 
chapter on the management of troublesome 
children is excellent. 

Part second deals with the eye, and there 
are six chapters, as follows: 11, Anatomy 
and Physiology; 12 and 13, Common Reme- 
dies Used in the Treatment of the Eye (Anti- 
septics, Anaesthetics, Mydriatics and Myotics, 
etc.) ; 14, Eversion of Lids, Retractors, Drops, 
Solutions, Ointments; 15, Contagious Eye 
Diseases (the Nurse's Duties at Operations, 
Anaesthetics) ; 16, Eye Instrurr.ents and Ap- 
pliances. 

Of these, the chapters on the conmon 
remedies employed in the treatment of eye 
affections, and the care of those suffering 
from contagious eye diseases, are dcservin-ij 
of special mention. 

The third part is on the Ear. The five 
chapters are: 17, Anatomy and Physiology 
of the Ear; 18, Examination of the Ear (Gen- 
eral Method and Instruments Used, Tests for 
Hearing) ; 19, Diseases of the Auricle and 
External Auditory Canal ; 20, Middle Ear Dis- 
eases (Preparation for Mastoid Operation); 
21, Diseases of the Internal Ear (Suppura- 
tive and Non-suppurative Labyrinthitis). 

The section on Mastoid operation is worthy 
of comment, as also is the chapter on exam 
illation, with tests for hearing. 

Part four considers the Nose. Here are 
two chapters (22) on Anatomic Description 
of the Nose and Accessory Sinuses, and (23) 



184 



THE TRAINED NURSE AND HOSPITAL REVIEW 



on Diseases of the Nose. The description 
of the Accessory Sinuses is brief and at 
the same time comprehensive. Under the 
diseases, there are short paragraphs on the 
various forms of Rhinitis (Acute, Chronic, 
Atraphic, Membranous, etc.), Epistanis; Hay- 
fever. Lupus, Tuberculosis, Syphilis, Devia- 
tions of the Septum Nasi, Fractures and 
Sinusitis, and the treatment of each condition 
is briefly outlined. 

The fifth and last part is devoted to the 
Pharynx and Larynx. The three Chapters 
are: 24, Anatomic Description of the 
Pharynx; 25, Diseases of the Pharynx 
(Pharyngitis, Tonsillitis, Adinoids) ; 26, the 
Larynx (Anatomy, Examination, Laryngeal 
Oedema, Benign and Malignant Tumors, 
Tuberculosis, Syphilis, Foreign Bodies, Irriga- 
tion, Inhalations, Tracheotomy, etc.). 

A well-compiled index completes the 
volume. There are many cuts of in- 
struments to enable the nurse easily to 
familiarize herself with their names and ap- 
pearance, and the book is profusely illustrated 
with half-tones from original photographs 
by Dr. E. G. Zabriskie. 

The nurse who wishes to engage in eye, 
ear, nose and throat work will find in this 
book a clear and concise exposition of all 
the necessary details coming under those 
headings. E. F., Jr., M.D. 



periments, symptoms, heredity, statistical es- 
timates, etc. This we find most excellent. The 
author has given instruction and information 
that caniK)t help but prove of value to women, 
who, for the most part, are very imperfectly 
informed on these subjects. 

Unfortunately this portion of the book oc- 
cupies but a scant third of the volume, and 
when the author branches off into other sub- 
jects, namely, Prostitution and The Preven- 
tion of Venereal Disease, she is most uncon- 
vincing and seems to have gone beyond her 
depth. She believes that the social evil de- 
mands not regulation, but complete suppres- 
sion, and has approached her subject from 
this standpoint. She places the social evil in 
the same list with smallpox, typhoid and tu- 
berculosis, and would deal with it accordingly. 
Consequently she loses sight and takes no ac- 
count of such things as human passions, hu- 
man desires, human frailties. Moreover, we 
read but a few pages before we come amuck 
of the author's pet hobbies, sex antagonism 
and votes for women. In fact, when all is 
said, we must allow that the greater part of 
the book is simply an argument for votes for 
women. There will be a long process of hu 
man evolution before Miss Dock's dream of 
uncompromising suppression of the social evil 
can be seriously considered except as an iri- 
descent inspiration. 



Hygiene and Morality. A manual for 
nurses and others, giving an outline of the 
medical, social and legal aspects of venereal 
diseases. By Lavinia L. Dock. For sale by 
The Lakeside Publishing Company. Price 
$1.50. The author tells us that the plan of 
this manual has grown from the scope of a 
paper presented by the author to the Interna- 
tional Congress in London, and that the chief 
purpose aimed at is to point out the social 
significance of the venereal diseases and the 
crusade upon which women should enter in 
regard to them. Therefore, though the book 
is designed primarily for the nursing profes- 
sion, the author hopes it may be useful to 
many other women as well. 

The book is divided into three parts, the 
first, The Venereal Diseases, gives the his- 
torical outline, cause, general results of ex- 



Pocket Therapeutics and Dose Book. By 
Morse Stewart, Jr., B. A., M. D. Fourth edi- 
tion, rewritten. Small 32mo of 263 pages. 
Cloth, $1.00 net. For sale by the Lakeside 
Publishing Company. 

In the fourth edition of this very useful 
and concise manual the text has been thor- 
oughly revised, all obsolete remedies omitted 
and newer ones added. It covers prescription 
writing, abbreviations, classification, therapeu- 
tic uses and dose table, index of diseases and 
remedies, tables of poisons and antidotes — in 
short, it contains in small space an immense 
amount of information regarding medicines 
in general. It is designed for the use of phy- 
sicians, nurses and pharmacists, and a copy 
might very profitably be hung in or near 
tvery medicine cupboard in hospitals for daily 
reference. 



THE EDITOR IS NOT RESPONSIBLE FOR THE VIEWS OF CONTRIBUTORS 



Reply to Manila Nurse. 

The letter given below is written in reply 
to a letter which appeared in the August, 1909, 
number of The Trained Nurse, over the 
signature, "Manila Nurse." See Editorial. 
To the Editor of The Trained Nurse: 

Anonymous communications are never 
worthy of either publication or reply, but as 
your magazine has seen fit to print the iim- 
signed article on the Phillipine Service, which 
is but a series of misstatements, it is, per- 
haps, just as well to print a signed one from 
a person who knows the facts. 

I will take the inaccuracies of this "Manila 
Nurse" in the order she has set them forth. 

The only nurses who are caring for leprosy 
in the Islands are the French Sisters of 
Mercy. No American nurse has ever been 
asked or expected to do this service, nor do 
they ever come in sight of or contact with 
lepers unless of their own volition. To the 
credit of our profession, be it known how- 
ever, that recently as many as five American 
and English nurses have written to the un- 
dersigned and asked for positions in the 
Culion Leper Colony, where the Lepers of the 
Philippines are segregated, but thus far their 
applications have not been considered. The 
Baguio Hospital is situated in the mountains 
in one of the most beautiful locations to be 
found anywhere. One leaves Manila by train 
at 6 A. M. and arrives at Camp No. i at 3 
P. M., and takes the remainder of the jour- 
ney by automobile over one of the finest 
mountain roads in the world, arriving at 6.00 
P. M. the same day. So much for the "day 
and a half trip referred to by this well in- 
formed (?) "Manila Nurse," who says nothing 
of the gorgeous scenery which makes this 
trip a memory of a lifetime. 

In March, 1909, the undersigned agitated 
the question of laundry allowance. The mat- 
ter was put before the Legislature, the bill 



passed, and the Government has paid for the 
nurses' laundry since August i, iQOQ- The 
"Manila Nurse" fails to state however, that 
laundry is the cheapest thing in Manila. Seven 
(7) centavos per piece is a very good price, 
while many Chinamen will take it for five 
rnd six centavos. A centavo being but a half- 
cent in our money, laundry costs but from 
2^ to 3^ cents United States currency per 
piece, A dress can be one piece if the skirt 
and waist are made together. A pair of stock- 
ings is one piece, also a handkerchief or belt. 
Though we wear white all the year round, 
I doubt if any nurse under any circumstances 
would consider such laundry rates a hard 
ship. 

The Government will actually pay a nurse's 
transportation to Manila in advance (except 
incidentals). For the protection of the Gov- 
ernment, however, this sum is deducted at the 
rate of 10 per cent, of their salary per month 
until the expiration of two years time, when 
it is all refunded, and even her bill for in- 
cidentals is reinfbursed as well as half salary 
for the time consumed in the voyage across. 
In the opinion of the undersigned, this is not 
only fair but most generous. Naturally if a 
nurse resigns before her two years has ex- 
pired, this money is forfeited. As it never 
came out of her own pocket, it can scarcely 
be considered a personal loss. 

All nurses are informed before they come 
out here that return transportation is not 
paid. She can always get Government rates 
on the liners however, which is $100.00, less 
than the regular passage though the accom- 
modations are the same, and very often can 
get return transportation on a transport which 
costs nothing but subsistence, at the rate of 
$1.00 per day. 

Concerning hours of duty, this "Manila 
Nurse" has again deliberately misrepresented 
the case. There are never more than three 



IS^S 



THE TRAINED NURSE AND HOSPITAL REVIEW 



American nurses on duty at night, generally 
but two, and two American attendants. The 
nurses have been getting, in regular rotation, 
two weeks midnight duty, two weeks after- 
noon duty and four weeks of morning duty. 
Thus it will be seen that a nurse gets eight 
hours night duty actually two weeks out of 
every eight — instead of four out of every six, 
as our mis-informant tells us. It is expected 
that within a month or two, the pupil nurses 
will be put on night duty with a one-night 
superintendent in charge, which will lessen 
night duty for the regular nurses. 

We note with pleasure one truthful state- 
ment: "The work itself is not particularly 
hard." The office time-book shows a daily 
average of fourteen American nurses (includ- 
ing the superintendent), five American attend- 
ants, six Filipino attendants, thirty-seven 
muchachos (ward boys, etc.), besides the of- 
fice force and a daily average of about thirty 
pupil nurses (who do five hours duty a day, 
cither morning or afternoon). This force to 
take care of a daily avci^ge of sixty-five 
house patients! These figures are taken from 
February, 1909 (when the undersigned went 
into office) up to the present time, and since 
the beginning of her so'vice in the Civil Hos- 
pital (November, 1908) she has never known 
a nurse either at San Lazaro or the Civil 
Hospital to be asked to do or assigned to 
twelve-hour duty! 

The "Manila Nurse'* states that "no excuse 
is adequate for the condition of the American 
nurses' quarters." Enclosed are photographs 
of the nurses* homes at San Lazaro and Civil 
Hospitals* The former is new, sanitary and 
thoroughly attractive. The second is an old 
Spanish home, in very bad repair, but so at- 
tractive that when arrangements were made 
nearly three years ago to rent new but less 
attractive quarters and the nurses were 
ordered to move into them, they flatly re- 
fused to go, prefering the old place on ac- 
count of its picturesqueness. 

Seniority of service has been eliminated as 
the factor in promotions, for by such arrange- 
ment we would have had some very undesira- 
ble persons in positions of responsibility. 

Following are some sample questions and 
answers from the examination papers of a 



♦Published in the May number. 



woman who poses as a nurse, and who man- 
aged to stay in the service six years. 

Question: Describe the Kelly pad and its 
uses. 

Answer: The Kelly pad is used princi- 
pally in cases of fracture and dislocation. 

Question: What is the lochia? Describe 
the changes that take place in it in a return 
to the normal condition after labor. 

Answer: After child labor the lochia con- 
tracts and becomes its normal size. 

Question: What is opthalmia neonatorum? 
What attention to the child is necessary to 
prevent its occurrence? 

Answer: The child should be well nour- 
ished and kept in a hygiene way of living. 

This person stayed in the service six years 

and is now one of our chief complainants. 

Can anyone believe that even sixteen years 
of service (unless in a training school) would 
ever render such material fit fcr promotion 
to advanced and responsible positions? An-l 
would it be fair to a new applicant who 
might be really capable and intelligent to be 
made subordinate to a woman of this calibre? 

Great was the indignation recently when 
the undersigned refused to recommend the 
rc-appointment of a nurse who had served 
four years but whose examination papers 
were barely passing. This nurse in describ- 
ing the care of the new-born infant's eyes, 
advocated the use of nitric acid! She also 
failed utterly in endeavoring to give the 
apothecaries weight 

And so the past twelve months have been 
engaged in "weeding" out the service and 
making vacancies for the desirable applicants. 
If the "Manila Nurse" would be honorable 
enough to sign her name, she would be found 
to be one of the "weeds." We want fine 
women over here, women who know the 
meaning of "loyalty" and "service" and 
"honor." We know such nurses exist and 
we intend to have them in the Philippines. 

There is no greater field for American 
women, and considering the "nature of their 
work and their hours of service, the nurses 
of the Philippine Civil Service are the high- 
est paid and most generously treated of any 
institutional nurses in the world. 

Very truly yours. 

Mabel E. McCalmont, R. N., 
Supt. Civil Hospt. Div., Supervising Nurse, 

Bureau of Health. 



ADVERTISEMENTS 



^ 
/ 



^ by [^jr»cun> everywlMre. \ 

Powdot. It not only smooths I 

ou^ineu and nwneit but h — *~ **-- 



fi 



Mennen't B 
Is as necessa 



188 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Reply to Miss McCalmont's Statement in 

May Number. 

To the Editor of The Trained Nurse: 

In the May number of The Trained Nurse, 
in the Nursing World Department, I notice 
an article by Miss Mabel E. McCalmont re- 
garding the Phillipine Service for nurses. 

For the benefit of nurses who may be con- 
templating entering the service I should be 
very glad if you would give space to the fol- 
lowing statements from one who has seen 
service in the hospital since Miss McCalmont 
took charge. 

The article in question reads very fairly 
and if the Civil Hospital was managed with 
equal fairness there would be little cause for 
complaint. 

As a matter of fact, considerable reading 
between the lines is necessary. 

Between February, 1909, and January, 1910, 
fourteen nurses severed their connection with 
the Bureau of Health and two more have done 
so within the past two weeks. 

The Civil Hospital is entitled to a force of 
seventeen graduate nurses, but has not aver- 
aged twelve on duty for the past year and a 
half unless I have been wilfully misinformed. 
With fourteen changes in this small staff 
within less than a year, the service could 
hardly be very attractive. 

All these nurses have left for the same 
reason (i. e., the unbearable conditions ex- 
isting at the hospital since Mass McCalmont 
took charge), although for policy's sake they 
have not all put this charge in writing. 

These nurses had served anywhere from 
seven years to one month in the Bureau of 
Health and numbered retired Army Nurses, 
Federal Civil Service Nurses and nurses who 
had filled hospital positions in the States. 

Seven of these fourteen nurses who have 
left the Civil Hospital have transferred to 
the Bureau of Education, and although they 
had had no previous experience as teachers, 
they have been successful in their new work 
and all agree that they have been well treated 
in the Bureau of Education. I will enclose 
a clipping from the Phillipine Free Press 
(one of the Manila papers which circulates 
among both Americans and Filipinos). The 
May Trained Nurse also contained pictures 
of the nurses' quarters at the Civil Hospital, 
also at San Lazaro. The entrance is beauti- 
ful, but the quarters themselves are old and 



terribly unsanitary, and are utterly unfit for 
the home of an American woman. 

An ample allowance is made by the As- 
sembly to the Bureau of Health to provide 
good quarters and good food for the nurses, 
neither of which they get. The food is al- 
most uneatable. The existing conditions have 
been reported to the head of the department 
many times and an investigation asked for. 
The only result of these requests has been 
petty persecution. In one case the head of 
the Bureau is reported to have told a nurse 
who was making an effort to get justice to 
"go and bust yourself." 

The unsuspecting nurses in the States who 
read articles Hke Miss McCalmont's and do 
not read between the lines the actual condi- 
tions come out here (seventeen thousand 
miles from home and usually without money 
or friends) and find that they are bound by 
contract for two years of service in a bureau 
in which justice and fairness are unheard of 
and where Might makes Right. 

One Who Knows. 



Civil Hospital Needs an Investigation. 

"From the beginning it might be said of the 
Civil Hospital as of man that it has been "full 
of trouble." Many persons here will remem- 
ber the Yemans-Stafford imbroglio in the 
early days and there seems to have been more 
or less of imbroglio ever since. 

"There is probably not a newspaper in 
Manila which has not been approached sev- 
eral times in the past year or two and urged 
to ventilate the affairs of the hospkal with 
a view to reform, and there is probably not 
a newspaper which has not shrunk from the 
task, for it is not a pleasant one. 

"The Free Press opens the matter at this 
time in response to repeated and insistent 
urging. There are many features of the hos- 
pital as now conducted which are very un- 
satisfactory both to the nurses and the 
patients. The burden of many of the com- 
plaiints is the questionable economy being; 
practiced by the present superintendent, Mjss 
McCalmont, with the sanction of the director 
of health, Dr. Heiser. Were there no loss 
of efficiency from such economy it would 
stand to be commended, but when, as is testi- 
fied in many cases, such economy goes so 
far as to result in a lack of ice, a lack of 



ADVERTISEMENTS 



190 



THE TRAINED NURSE AND HOSPITAL REVIEW 



milk and cream, a lack of clean linen, and 
even a lack of spoons, it is time to call a halt. 

"As a result of this state of affairs there 
have 'been many protests from patients during 
the past few months, and people are being 
advised not to go to the Civil Hospital for 
treatment. 

"Dissatisfaction — and that is a mild word — 
has also arisen over the treatment of the 
nurses by Miss McCalmont. At least three 
or four are said to have resigned on her ac- 
count. 

"There are a number of other features 
which might be broached and, taken alto- 
gether, they are certainly sufficient to call 
for an investigation. And if the Secretary 
of the Interior has the welfare of the hos- 
pital at heart he will order an investigation 
upon his return from his present trip through 
the northern provinces." 

+ 
In Defense of Miss Nelsen. 

To the Editor of The Trained Nurse: 

Having read with interest the article writ- 
ten by Miss Nelsen in the May number of 



this journal, also the various criticisms and 
her own explanation pertaining thereto, 1 
wish to express my views of the subject. I 
can readily understand how she was obliged 
to send in such a large order for things 
needed about the sick room. I have been in 
the country myself many times and have had 
to put up with just such conditions and know 
whereof I am speaking. My experiences were 
not in the least to be desired. Fifty yards 
of mosquito netting are but a "drop in the 
bucket." I should think it strange more was 
not used. As for the bedbugs! Well, she 
did her best, I am sure, to exterminate them. 
There is one question I would like to ask. 
Why would not two bedpans have been suf- 
ficient? They could have been disinfected 
alternately. The nurse did the best she could 
under all the circumstances and I see no 
reason why she did not get her full pay. The 
people were, to say the least, extremely un- 
grateful. No matter what method a nurse 
may employ in taking care of a case, some 
one is sure to find fault with it. 

Florence R. Pond. 



Changes In Army Nurse Corps. 

APPOINTMENTS. 

Evangeline Duffy, graduate of Saint 
Joseph's Hospital, Philadelphia, Pa., night 
superintendent of Garretson Hospital, Phila- 
delphia, and superintendent of Training 
School, Saint Joseph's Hospital, Lancaster, 
Pa. 

Clara M. Ervin, graduate of Worcester In- 
sane Hospital, Worcester, Mass.; also super- 
vising nurse at Worcester Hospital, and 
nurse at Bellevue Hospital, New York City. 

Myra Eva Hummel, graduate of the Hospi- 
tal of the Protestant Episcopal Church, Phila- 
delphia; also assistant superintendent of the 
Lying-in Charity Hospital, of Philadelphia. 

Cora Miller, graduate of Samaritan Hospi- 
tal, Troy, New York. 

Rhoda M. Wright, graduate of the Mon- 
mouth Memorial Hospital, Long Branch, New 
Jersey. 



DISCHARGES. 

Anna L. Davis, July i, 1910; Mary H. Hal- 
lock, August 8; Louise Maguire, August i; 
Ethel J. Pinches, July 13, and Valeria Rit- 
tcnhouse, August 8, 1910. 

TRANSFERS. 

From San Francisco to Fort Bayard, New 
Mexico, Edith H. Rutley. 

From Philippine Division to San Fran- 
cisco, July 12, 1910, Gertrude H. Lustig and 
Valeria Rittenhousc; August 12, Lyda M. 
Keener and Elizabeth D. Reid. 

From San Francisco to Philippines Divi- 
sion, Anna B. Carlson, Carrie L. Howard, 
Sarah T. Little and Bessie Kelly (from Fort 
Bayard), on August 5, 1910. 

From Division Hospital, Manila, to Camp 
Keithley, P. L, Florence W. Thompson, 

From Camp Keithley to Division Hospital, 
Manila, P. I., Junia Hattie Latimer. 

Jane A. Delano, 
Superintendent Army Nurse Corps. 



ADVERTISEMENTS 



Jin tm ^nxm^ Waxltt 

ARTICLES IN THIS DEPARTMENT, WHETHER BEARING SIGNATURE OR NOT, ARE CONTRIBUTED. AND 
no NOT NECESSARILY REPRESENT THE IDEAS OR POLICY OF THIS MAGAZINE 



Massachusetts.* 

Dr. Hugh Cabot: When I received the re- 
port of the American Hospital Association, 
which was kindly sent me some weeks ago, 1 
read it with very great interest and pleasure, 
and was struck, as has been previously said, 
by the great similarity in the construction of 
that association to this. The same elements 
are at work there as have been at work here, 
except that they cover a wider field and have 
a more representative body. 1 was sorry when 
I received the circular of their meeling that 
I was not a member of their association and 
was not going to hear their papers, because it 
seems to me a very powerful association, 
which is bound to have very great effect. The 
temper of this report struck me as being sur- 
prisingly good, suipiisingl) 111 lie \\\>\\ wliieli 
even the most captious c(»nM lind fault, Th<* 
crux of the situation, I think, is going to 
come, if I remember rightly, in class i of their 
hospital classification. Yes, isolated small hos 
pitals, which, as is properly stated here, is, I 
suppose, very much the largest class and the 
increasing class. The mushroom growth of 
small hospitals is the characteristic condition 
of the last fifteen or twenty years. The solu- 
tion of the problem of their nursing seems 
to me to be in combination. Each one of 
them undoubtedly has certain valuable and 
peculiar characteristics. If there were com- 
binations between small hospitals and special 
hospitals, especially such hospitals as clearly 
ought not to maintain a Jtaining school, and 
yet which can give a very valuable training 
along a rather narrow line. Now, if they were 
supplied with nurses, we will say, from half a 
dozen small hospitals situated throughout the 
surrounding one or two hundred miles, thrse 
nurses to serve for a sufficient length of time, 
perhaps six months, both would benefit. The 



•Continuation of tlip repurt of the tenth 

semi-annual n.eetinp: (a* the New F^ng-land As- 

SK>ciatlon for the Kdiicailion of Nurses, ilhe su-l)- 

ject under <IIscus5<lon heinp the training' soho >1 

repori o.f the llo-^plt-al As.-sociation. 



special hospital would be supplied with all the 
nurses needed, who had a good general train- 
ing. The small hospitals would be supplied 
with what they couldn't get in any other way, 
special service, and their nurses would be 
getting a training closely approximating that 
of the larger institutions. In this way it 
might, I suppose, be possible to give a three 
years' course. In other words, these different 
hospitals would work together somewhat after 
the plan of medical education in England, 
where a student may study in any one of half 
a dozen diflferent schools and ultimately get 
his degree from the State. Possibly some 
such arrangement might be necessary here — 
that the ultimate diploma should be given by 
some larger body, perhaps under some system 
of registration, or combination between smaH 
and large hospitals; and every type of train- 
ing could be given. This is certainly true of 
the eastern part of the country. Of the west- 
ern part I know very little, but in the eastern 
part I believe such co-operation could be ar- 
ranged if there were anybody to arrange v. 
If thai committee of Dr. Washburn's wi 1 
take it up, it will go a long way towards put- 
ting it through. 

There are a large number of schools in hos- 
pitals throughout the State and in neighbor- 
ing States which seem to me very badly off : 
they necessarily give a very imperfect train- 
ing. They must have a training school. It is 
evidence of the growth of the hospitals thai 
it has created training schools for nurses; it 
is the enormous growth of snail hospitals 
ihat has multiplied the production of nurses. 
Many of those nurses are well trained, some 
of them are not, cannot be, well trained, and 
yet the hospitals where those nurses were 
trained must exist. These hospitals have conij 
not by r.ccidcnt, but as an economic necessity. 
They arc here to stay. The number is in- 
creasing. They can, 1 believe, be provided for 
by some system or other of combination, and 
in the Eastern States, where they arc pretty 



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r 



ead Directions 

Carefully 

Before attempting 

to make 

Postum 



Palatability in food or drink is of 
the greatest importance. Unless "it 
tastes good" and "smells good" no food 
or beverage is likely to pass the lips of 
the average individual — the sick or con- 
valescent, above all. 

Many nurses fail at first trial to 
produce a palatable drink in preparing 

Postum. This is because Postum looks like cofTee and is prepared in a 

similar r 



Postum, however, must be boiled at least 15 minutes to make 
it palatable. It should be a dark and rich brown in color, changing 
to a golden brown when cream is added. Then it is as delicious and 
palatable as fine Java coffee. 

But — Postum contains no coffee (hence no caffeine) nor any 
other harmful substance; "harmful" meaning that caffeine is such, 
not when administered by the physician, but in daily triple doses of 
2 to 5 grains in coffee or tea. 

By reading the directions carefully on the package, anyone 
can make "good rich Postiun" which is not only palatable, but 
nourishing. 

The "Clinical Record" for the physcian's bedside use, with name 
stamped in gold letters on cover will be sent to any physician who 
has not already received a copy. .'\lso prepaid sample box of Postum 
and Grape-Niits for clinical experiments. Doctor, please ask for 
what additional Clinical Record Inserts you need from time to time. 
They're free to you. 

PoBtum Cereal Company, Ltd., Battle Creek, Mich., U. S. A. 



ntiin The Thai 



194 



THE TRAINED NURSE AND HOSPITAL REVIEW 



permanent, such a system could be made to 
work. In the Western States they are of 
mushroom growth, I aui told; they grow rap- 
idly and disappear quite as fast. That isn't 
true of the East, and isn't likely to be; and 
if it is true of the West now, it may not be 
true in the future. At any rate, here, the 
problem, as I see it, must, I think, be solved 
in some such way. 

In regard to the training of so-called nurses' 
attendants, the difficulty, it seems to me, is 
that we have tried to get something for noth- 
ing. I never knew anybody to get away with 
that yet. You are trying to get people, who 
very soon feel as if they were doing a nurse's 
work— of course, they are not doing a nurse's 
work, no one who sees any of their results 
would make any such blunder — but they think 
they are, and they promptly get dissatisfied. 
I think my experience, though more limited 
than Dr. Patch's, is the same. I have never 
seen one who was worth what she was paid, 
though they are paid little enough. I am in- 
clined to agree with Dr. Patch that the more 
extended use of the undergraduate is likely 
to be the solution of the problem. I think, 
as Dr. Worcester has suggested, it means the 
modification of our nursing accommodations 
at the hospitals. That must come. It means 
that, for instance, in the large cities where 
the demand is perhaps more pressing, the city 
must pay to the training schools sums of 
money sufficient to pay for such training. It 
can be done, it can be arranged; I have no 
doubt that from the taxes one could persuade 
the city to pay it if the need was made as 
clear to the general public as it is to those of 
us who see it at first hand. It does not seem 
to me probable that it would be difficult to 
provide the sinews of war if it becomes clear 
that it is by undergraduates that this problem 
is to be solved, and it seems to nic it would 
be better solved that way than by the training 
of half-baked people who always wonder if 
they hadn't better go and get baked some 
more. 

+ 
Rhode loland. 

Twenty-nine graduates received their diplo- 
mas at the graduating exercises of the class 
of 1910 of the Rhode Island Hospital Train- 
ing School for Nurses, Providence, May 26, 
1910. The speakers of the evening were Pres- 
ident W. H. P. Faunce, of Brown University, 



and Miss Mary M. Riddle, Superintendent of 
the Newton Hospital, Newton, Mass. 

Those who received diplomas are Helen 
Hulme, Katherine Knox, Isabella Chew, Annie 
McCaughey, Mary Cornelia Bliek, Ruby Cathe- 
rine Murphy, Mattie Luella Taylor, Sadie 
Evelyn Handleman, Emily Margaret Arm- 
strong, Mary Anne O'Neill, Helen Alcorn, 
Harriet Maria Goulding, Bertha Benson, Sa- 
rah MacKenzie, Laura Janet Harris, Emma 
Marion Rousseau, Sarah Theresa Leion, Edna 
Estella Lord, Jennie Alberta Thomas, Amy 
Elma MacLean, Eva Lena Berthiaume, Maud 
H. Bartlett, Mary Elizabeth O'Rourke, Flor- 
ence Thorpe, Marcella May Duff)', Gertrude 
Winifred Dunn, Margaret Mary Coutanche, 
Margaret Davis and Mae Price. 

+ 
Pennsylvania. 

The eleventh graduating class of the Kane 
Summit Hospital held its exercises at the 
Presbyterian church on Tuesday evening. May 
31. The class consisted of four members, 
Misses Kathryn Bowman, Grace Ellsworth, 
Mildred Bailey and Margaret Plunkett, who, 
unfortunately, through sickness, was unable 
to attend. Class motto: "Not for Ourselves 
Alone." The church was beautifully decorated 
with the class colors, blue and gold, and palms 
and cut flowers adorned the 4)ulpit and chan- 
cel. An excellent programme was rendered. 
•Following the invocation by Rev. George A. 
Sutton, the choir of the Presbyterian church 
sang their first selection, "Lead Thou Me On." 

Dr. W. P. Burdick was then introduced by 
Rev. Sutton, and gave the address of the 
evening. 

Miss Burkhardt followed with a solo which 
was excellently rendered. The presentation 
of diplomas and badges was next in order, af- 
ter which the choir sang the "Cradle Song" 
by Henry Smart. The exercises were closed 
with the benediction by Rev. Irvin T. Geist- 
weit, after which a reception was held in the 
hospital parlors, and was largly attended by 
friends and guests. Refreshments were served. 



The New Thompson House, Kane, was the 
scene of a very brilliant social function May 
30, the event being the tenth annual reunion 
and banquet of the Nurses' Alumnae Associa- 
tion of the Kane Summit Hospital. 

It was nearly 10 o'clock when the summons 
to the banquet hall was made. Here a most 



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TYPES OF ANEMIA-No. 8 



THE ANEMUOF ADOLESCENCE 

cbouU never be reoarded as miiinpmtanl or 
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the one especially palatable, non^rritant, readily 
absorbable, non-constipating blood builder and 
general reconstructive tonic 

Ib •laran-ouBca bottUi Balr.— N«Mr mU In btdk. 



M. J. BRETIENBACH CO^ New York. U. S. A. 



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A Drink in Fevers 



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to a glass of cold water makes a cooling and re- 
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Its superiority over Dilute Phosphoric Acid, or 
any other acid, is due to the fact that it contains 
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When you writ* Advertisers, p1»bh mention Turn Tujnbd Ndsbm. 



196 



THE TRAINED NURSE AND HOSPITAL REVIEW 



pleasing sight greeted the eye, as the tables, 
resplendent with their floral decorations, snowy 
linen and bright silverware, seemed to invoke 
one's appetite, and it is needless to add that 
all did ample justice to the six-course spread. 

As the hands of the clock pointed to 12, the 
toastmistress, Mrs. Anna Stall, arose, and in 
a very neat speech introduced the first speaker, 
Mrs. Katherine Hot tell, who responded to the 
subject of "The Doctor" in a very witty man- 
ner. "The Line of Duty" was most ably pre- 
sented by Mildred Bailey. Dr. W. P. Burdick 
responded to the toast "Nothing" in a man- 
ner that left nothing to be said on this sub- 
ject. "Practical Nursing," by Esther Carlson, 
was ably presented. 

Mr. R. J. Sharp's subject, "Ad Libitum," 
gave this gentleman an opportunity of dis- 
playing his oratorical ability to good advan- 
tage. "The Class 1910" was most interestingly 
presented by Ruth Shaw. Miss Shaw has an 
case of manner which makes it a pleasure to 
listen to anything she has to say. "Opportun- 
ity" was the subject assigned to £. K. Kane. 

"The Human Machine," by Maude McDev- 
itt, brought out many good points as to the 
life of a nurse. The theme "Kane Summitt 
Hospital" was presented by R. K. Godtling, 
who took the newspaper man's view of this in- 
stitution, c*ting instances of the good that he 
had seen done at this institution. 

Good nights were then exchanged, and the 
company dispersed to their respective homes, 
feeling that they had not only enjoyed a de- 
lightful evening socially, but that it had been 
good for them to be there. 



The Alumnae Association of the Adrian 
Hospital Punxsutawney, held its semi-annual 
business meeting at the home of Miss Harriet 
Bright, at DuBois, Pa., July 6, 1910. 

Eleven members were present, namely, Mrs. 
Marion Cockran (nee Brian), Mrs. Chester 
Fugate (nee Jones), Misses Lillian Humphrey, 
Elizabeth Hunger, Martha Hower, Erie Smith, 
Elizabeth Hutchinson, Agnes Cook, Mary 
Moore, Harriet Bright and Fannie Loudon. 

The following new members were received: 
Misses Agnes Brounlie, Cora Foltz and Ruth 
Brian. Officers were elected for the ensuing 
year: Miss Erie B. Smith, president; Miss 
Harriet Bright, vice-president; Miss Fannie 
Loudon, secretary, and Mrs. Chester Fugate, 
treasurer. Miss Lunetta Miller donated to 



ihe Alumnae Fund a beautiful silver tea set. 

Following the business session we adjourned 
10 the Commercial Hotel, where Di. S. M. 
Free entertained us at dinner, which was 
greatly enjoyed by all. 

The next meeting will be held at Adrian 
Hospital the first Wednesday in January, 191 1. 

Miss Ellen Brian, of Brockwayville, Pa., 
and Mr. Marion Cockran, of Punxsutawney, 
Pa., were married in the Episcopal church at 
Sugar Hill, Pa., April 6, 1910. The bride was 
a graduate, of class '05. 

Miss Stella Downey, of class '04, and Mr. 
Morton B. Collins of Monogahela City, Pa., 
were married April 20, 1910, in the St. Paul's 
Episcopal Church. 

Miss Alta McMillen, of class '09, and Dr. 
J. E. Hardman, were married in the Roman 
Catholic church at West End, Punxsutawney, 
Pa., April 27, 1910. 

Miss Emily Campin, of class '04, and Dr. 
Chester F. Miller were married, at Benton 
Harbor, Mich. 

Miss Barbara Hutchinson, of class '07, and 
Mr. Wilbert McCauslin, of Butler, Pa., were 
married at the home of the bride's uncle. Rev. 
S. T. Himcs, Braddock, Pa., May 12, 191 o. 

+ 

District of Columbia. 

The Nurses' Examining Board of the Dis- 
trict of Columbia will hold examination of 
applicants November 9 and 10. Applications 
must be filed with secretary before October 15. 

+ 
Ohio. 

The second annual commencement of the 
White Hospital Training School for Nurses, 
Ravenna, was an entertaining event at the 
Congregational church Tuesday evenmg. May 
24, leaving pleasurable memories with the 
large audience that gave close and interested 
attention to the programme. The church was 
tastefully decorated for the occasion, and the 
music by the ladies' chorus was very enjoy- 
able. 

S. F. Hanselman, secretary of the board 
of trustees, presided, and Dr. L J. Swanson 
opened the exercises with invocation. After a 
selection by the ladies' chorus, Mr. Hansel - 
man gave a brief description of the school, 
emphasizing the features of its organization, 
its officers, its instructors, its course of study 
and its commencements. He then introduced 



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1 



Therapeutic Dependability - 

the upfailing accomplishmeat (A 
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r Gray's Glycerine Tonic Gomp 

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198 



THE TRAINED NURSE AND HOSPITAL REVIEW 



the principal. Miss Benton, who made the re- 
port of the school 

The report was followed by the address of 
Dr. H. G. Sloan, of Qeveland, who took for 
his subject "The Nurse After Leaving the 
Training School." The presentation of diplo- 
mas was made by Mr. Hanselman. A recep- 
tion was tendered to the graduates in the af- 
ternoon at the home of Dr. and Mrs. White. 

+ 
Louisiana. 

Among the delightful midsummer affairs 
taking place in New Orleans was the love 
feast given to Miss F. M. Quaife, former 
Superintendent and Directress of Nurses at 
Touro Infirmary, now Matron at Vassar G>1- 
lege. New York. Miss Quaife spent a short 
time in the city, and most of the alumnae of 
the ten classes which graduated during her 
reign at Touro united and entertained at a 
banquet, to which a number of prominent phy- 
sicians were also invited. The Touro colors, 
blue and white, were effectively carried out in 
the table decorations. The entire party was 
conveyed to and from the banquet in tallyhos. 

Miss Quaife sailed for the East on July 13, 
and her departure was a veritable floral ova- 
tion, attesting to the affection in which she is 
held in New Orleans. A large number of her 
nurses gathered to wish her ban voyage. 

+ 
Married. 

A pretty home wedding was solemnized at 
Blaine, Ohio, on June 21, when Dr. A. J. 
Quimby, formerly of Wheeling, W. Va., and 
now of New York City, and Miss Gertrude 
Seabright, of Blaine, Ohio, were united in 
marriage. Mrs. Quimby is a graduate of the 
City Hospital, Wheeling, W. Va., class of '05. 



zenger is a banker. They will reside in Rock 
VaUey. 



In Ohama, Neb., June 14, ipio, L. Belle 
Snider and Frank Mendenhall, both of Tilden, 
Neb. Mrs. Mendenhall is a graduate of Sa- 
maritan Hospital, Sioux City, Iowa, class of 
'04. Mr. Mendenhall is a jeweller at Tilden, 
where they will reside. 



Miss Winifred Reaney was united in mar- 
riage to Mr. John A. Huizenger at Rock Val- 
ley, Iowa, July 16, 1910. Miss Reaney has 
recently had charge of the Rock Valley Hos- 
pital and is a graduate of the Samaritan Hos- 
pital, Sioux City, Iowa, class of '06. Mr. Hui- 



In Sioux City, Iowa, Miss Tida Draper to 
Mr. Alfred Swanson. Mrs. Swanson is a 
graduate of the Samaritan Hospital, class of 
'05. They will reside in Sioux City. 



The marriage of Adele Bassett Hieber, of 
Elyria, Ohio, to Dr. George Gill on July 25, 
1910^ has been announced. Mrs. Gill (nee Hie- 
ber) is a graduate of the Cooper Hospital, 
Camden, N. J., and also of the Pennsylvania 
Orthopaedic Institute, Philadelphia, Pa. 

+ 
Personal. 

Miss Charlotte M. Perry, late Superintend- 
ent of Faxton Hospital, Utica, N. Y., after en- 
joying a vacation and much-needed rest, has 
accepted the position of Superintendent of 
Grace Hospital, New Haven, Conn., and will 
enter upon her duties September i. 

Obituary Notes. 

Dr. Charles Jewett, widely known as a gy- 
necologist and as the author of many stand- 
ard medical works, died at his home. No. 330 
Clinton avenue, Brooklyn. 

Dr. Jewett, who was sixty-six years old, 
was suffering from cerebral hemorrhage and 
paralysis. He was born in Bath, Me., was 
graduated from Bowdoin College and from 
the College of Physicians and Surgeons. For 
many years he has been consulting physician 
to the Brooklyn, Kings County, Swedish, 
Bushwick and St Christopher's hospitals. 



Josephine Ethel Kuenemann, beloved daugh- 
ter of Robert A. Kuenemann, bom February 
5, 1884, died July 23, 1910. Miss Kuenemann 
was nursing on a private case when she was 
suddenly taken ill and died a few moments 
later. Funeral services were held at the home 
of her father at No. 39 Lakevicw avenue, Pat- 
erson, N. J., Monday afternoon, July 25, con- 
ducted by the Rev. D. S. Hamilton, of St. 
Paul's Episopal Church, who referred to the 
self-sacrificing spirit of the young 'woman, 
whose loss has caused sorrow among a wide 
circle of acquaintances. A number of nurses 
from the local hospitals attended the funeral, 
and many beautiful floral tributes were re- 
ceived. 



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Horsford's Acid Phosphate. 

Good results in partial paralysis and im- 
potency. Dr. F. M. Russell. 

Paw Paw, Mich. 

+ 
Horlick's Malted Milk with Egg. 

Eggs one or two, cracked ice sufficient, 
Horlick's Malted Milk one tablespoon ful, wa- 
ter sufficient to fill an ordinary glass or cup. 
Shake thoroughly and strain. Use Shaker. 

+ 
Used in Stubborn Cases. 

I have made frequent use of Resinol and 
have found it an excellent salve in some very 
stubborn cases of skin diseases where such 
a salve was indicated, and shall use it freely 
in the future. C. C. Jelliffe, M. D. 

New York City. 

+ 
Do Not Delay. 

Meaville, Pa., Jan. lo, 1910. 
Ogden & Shimer : 

Gentlemen — Please send me as early as pos- 
sible one jar of Mystic Cream. Can find noth- 
ing here equal to it. Yours very truly, 

Mrs. C. Theo. Campbell. 

+ 
Everlasting Satisfaction. 

Many a physician has found to his ever- 
lasting satisfaction that with the aid of Nes- 
tle's Food he can prepare a diet, not only as 
closely approximating mother's milk as seems 
necessary, but one subject to whatever changes 
his judgment dictates from day to day. More- 
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every danger of infection is elim mated. 

+ 
Free, but Valuable! 

Battle & Co., of St. Louis, have just issued 
No. 13 of their series of cliarts on disloca- 
tions. This series forms a most valuable and 
interesting addition to any physician's or 
nurse's library. They will be sent free of 
charge on application, and back numbers will 
also be supplied. If you have missed any of 
these numbers, better write Battle & Co. for 
them before the supply is exhausted. 



Thalosen (Abbott). 

Thalosen acts more satisfactorily with a less 
phenolphthalein content than any similar prod- 
uct. As here combined, one grain of the drug 
will do the work of two or more grains, given 
singly or as ordinarily combined. What is 
more, instead of de-sensitizing the bowel, it 
tends rather to impart tonicity to it, so that 
increase of dosage, as time goes on, is seldom 
necessary. 

+ 
Junket Buttermilk Tablets. 

Hansen's Junket Buttermilk Tablets may be 
taken directly as a medicine, two or three 
tablets with each meal, chewing them with 
other food. The pure lactic acid bacteria 
make their way to the lower mtestines, where 
they counteract the evil eflfect of putrefactive 
germs. The medium in which the bacteria in 
the tablets are preserved is sugar of milk, 
which is, of course, perfectly harmless. 

+ 
Proven Merit vs. Theory. 

The thing that counts—RESULTS— have 
proven that a cod liver oil product with the 
grease left out is as active therapeutically, and 
more so when its palatability is considered, as 
the greasy, nauseating, unrefined cod liver oil. 
It is this feature that has won for Cord. ExL 
01. Morrhuae Comp. (Hagee) the good 
opinion of a large share of physicians, and 
it is why they continue to use it day after 
day. 

+ 
Tonic Effect Lasting. 

The tonic effect of a cup of well-made 
Postum is genuine and lasting. That from 
coffee is fleeting and reactionary — the caffeine 
causing a subsequent depression of the ner- 
vous system. Postum is made of clean, hard 
wheat, and this includes the bran-coat, which 
contains the valuable tonic phosphates (grown 
in the grain), the elements nature requires for 
the elaboration of nerve cells. Postum may 
be used by every member of the family from 
the baby to grandmother, without harm, but 
real benefit 



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INSTRUCTION IN MASSAGE 

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OVER 9000 TREATMENTS GIVEN IN 1909 
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INSTRUCTORS 



Wm. EeBBST KeaamTiov. M.D. (Professor of Medi- 
cine. Temple University). 

Louis H. A. VON CoTZHAUSEN. Ph. G.. M. D. 
(Graduate Phila. Collese of Pharmacy, A ed. Dept. 
University of Penna..Penna. Orthopedic Institute). 

Wm. EawiM. M.D. (Hahnemann and Rush Med. Col.) 



If AX J. WALTaa (Univ. of Penna.. Royal Univ.. 
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ley). Mount Sinai and W. Phila. Hosp. for Women. 
Cooper Hosp., etc.) 

Hklemb BoM8DOKyF(Gym. Ins..Stockholm, Sweden). 

LxLLiB H. Makshall ((Pennsylvania OrthopsMlic 

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When you write Advertisers, please mention The Trained Nuesk. 



\ 



202 



THE TRAINED NURSE AND HOSPITAL REVIEW 



It's Pink. 
Arrow Brand Cream Polish is a scientifi- 
cally compounded polishing solution for auto- 
mobile brass work and all classes of work 
where a high grade, quick, thorough, easy- 
working and lasting polish is wanted for gar- 
ages, hotels, bars, sign cleaners and for the 
household. 

+ 
Our Hospital Devices. 
Our hospital devices are the results of our 
catering to the hospital trade, anticipating 
their needs and embodying them in a number 
of practical boards, simple in system, strong 
and durable in construction. 

It will be to your lasting advantage to send 
for circulars and be convinced. 

Universal Register Company, 
1409 W. Jackson Blvd., Chicago, 111. 

+ 
Mrs. Armstrong's Chocolate Pudding. 

Soften three cups of stale bread in an equal 
quantity of milk. Melt two squares of Walter 
Baker & Co.*s Chocolate over hot water and 
mix with half a cup of sugar, a little salt, 
three beaten eggs and half a teaspoon ful of 
vanilla. Mix this thoroughly with the bread 
and place in well-buttered custard cups. Steam 
about half an hour (according to size) and 
serve in the cups or turned out on warm plate. 
— Mrs. Helen Armstrong. 

+ 
Definite and Uniform. 
Listerine requires careful laboratory mani- 
pulation, and unusual length of time for per- 
fection; it is of definite and uniform antisep- 
tic strength, and may be relied upon to pro- 
duce like effects, under like conditions, where- 
as the substitutes and imitations so frequently 
offered by the trade are sometimes distinctly 
harmful, generally of undetermined antiseptic 
strength, and too often worthless for the pur- 
poses for which they are required. 

+ 
Toxic Anemia. 
The causative factor being once removed or 
materially modified, restorative and hematinic 
measures are distinctly indicated. It is espe- 
cially desirable in such cases to avoid the 
administration of drugs that tend to derange 
the digestion, and the ordinary, inorganic, me- 
tallic salts of iron should not be given, as 
they frequently prove irritant, astringent and 



constipating. Pepto-Mangan (Gude) is the 
ideal hematinic in any condition in which the 
integrity of the digestive functions must be 
conserved and maintained, as the necessary 
iron and manganese are promptly absorbed 
without irritating the gastric mucosa or in- 
ducing a constipated habit. 

+ 
Robinson's Patent Barley. 

Barley makes the most delicious and deli- 
cate dishes for those patients who must be 
on a light diet and have a capricious appetite. 
Many nurses never think of using it in any 
other way than for the baby. In the t)Ook- 
let which James P. Smith & Co., 80 Hudson 
Street, New York City, send out are given 
some excellent receipts and every nurse can 
have one of these booklets for the asking. 

+ 
The Original! 

The ACOUSTICON is the original elec- 
trical aid to hearing. It has had many imita- 
tors, but as the ACOUSTICON principle is 
patented, its results cannot be duplicated. 

The ACOUSTICON cannot be com- 
pared with old-fashioned tubes, drums, 
speaking horns, etc., that have brought partial 
relief to people in years past. These instru- 
ments merely transmit sound. Most deaf 
people require not only reproduced but ampli- 
fied sound and clarified articulation. 

See advertisement in this issue. 

+ 
His Secret of Success. 

"I do not sec how you have the success you 
do with old age," said one physician to an- 
other. 

"I'll tell you why," replied the second. "I 
believe I've found the only real solution oi 
the problem." 

"It's the use of a good malt extract. You 
know as well as I do how little can be done 
in such cases — a little toning is all. The 
breaking dowa of weakened tissues cannot be 
prevented nor remedied; so I just prescribe 
malt extract, taking particular pains to see that 
it is Pabst Extract, the 'Best' Tonic, for I 
know I can get the best results from that 
brand." 

The declining years of many an aged patient 
would be made much more agreeable and the 
approach of "the last enemy" .considerably 
postponed, were all physicians as Irank as 
chese two. 



ADVERTISEMENTS 



Philadelphia Orthopaedic 

Hospital and Infirmary 

for Nerroos Diseasei 



Tb. PHILADELPHIA ORTHO- 
PAEDIC HOSPITAL AND INRRM- 
ARY FOR NERVOUS DISEASES, a 
wbkh isMmclioo ib mMnge. coiTecti*a amd 
r*-«liiulioaal gyninwtiCT twi boa given (or 
fifteen yean, now prop m m to cstead md 
enUrge ibc Kspt of llui teaching, and oS«n 
■ count in |)mm lubjecU wiiicli il k bebaTsd, 
wiA lbs ETHl Tvicl7 hk! qiunii); of bwIo- 
lial for BMcmtioB and ptaclka at iIm cGi- 
potal of tlu toipilal. cannot tw equabd u 
tbit cooaiiy. 

Dnrini die yaar I90S Att mibiImi of 
trealmenti givon in di* onl-patieat deputmcnl 
by pnpik m tka mawage anid medkal-extRBo 
coune exceeded ten dtouand. Be«dei dd* 
adraneed piquk bare opportnniliea of ghiBf 
gcMial and ipBcial mMUfB to patwBli ■■ ibo 
boqiilel under i 



hyileria, cboraa. «lc^ and by ma w ag i and 
acne in cerefanl and •piual paialjrat, bifan- 
lile palqr, tranmatic inivriei of die ipinal cord, 
didocatioiii, joint atftoioni, diubilitia fol- 
lovring fraclnn*, bonii, Mian, etc.; ipioal 
curratuia and otbcr poatural dcfonnitia, Rat 
foot, dnb fool, contracturai and die handling 



BMOlba, begianhfl in Odober, 1909. Lactunt 
wiB be grm bjr Dr. J. K. MikheO. Dr. Wm. 
J. T^lor. Dr. a G. Dan*. Dr. Frank D. 
Dickion and Dr. Wm. J. Dtajrton. Jr.. wbOe 
die jKadicai i— Amg occnpiea from direa to 
(onr botm daily. 



Tloat iaiatm of entering iba cUm, whicb 
win be Caitod in nnmker, diauld apfdy to dw 
■operinkadenl of die boapital, who will lend 
a circular with detail* of die reqiuremeati for 
admnoon. Tba fee far diii coone i. $!«. 

A iborter coune of inlraction in the diera- 

peBtic nan <il Electridly, (iiitable for pufuk, 

r be lakes uridi dw nwcbano-dMrapy w 



1701 Ssnuner St, FUla., P>. 



When yoii write AdvertlBera, 



One of above special bottles of 
Olyco-T hymollne will be sent 

FREE 
Express Prepaid 

to any Trained Nurse on appli- 
cation. 

We want you to know the value 
of Qlyco-Thymoline. It stands 
on its merits. 

MoDtioQ thi» Magazioe. 
KRESS & OWEN COMPANY 
310 Fulton St., New York, 
please mention 1mm TaaiNSD NiiRei. 



204 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Trained Nurse Case. 

How many nurses have sent for the Jal- 
zahn Catalogue of Nurses Supplies? It is 
well worth your while to do this for the 
Valzahn Company, 1629 Chestnut Street, Phila- 
delphia, have some splendid values in things 
chat trained nurses need for equipping their 
emergency bags, and also for use in the sick 
room. See the adv. on front page in this 
number of the "Nonpareil" Trained Nurse 
Case. No nurse should be without this. 

+ 
Excite Gianduiar Secretion. 

Without the slightest irritating effect on 
even the most irritable gastric mucous mem- 
brane, Seng gently but effectively excites glan- 
dular secretions. An improved circulation fol- 
lows as a necessary sequence, and the ad- 
jacent tissues are correspondingly nourished. 
This means increased muscular tone and a 
much more effective motility of the gastric 
and intestinal muscular coats. Gastric mo- 
tility itself promotes secretory activity of the 
inner coats. 

+ 
Local Treatment of Nasal Catarrh. 

M. Clayton Thrush, Ph. M., M. D., of Phil- 
adelphia, reports having used Unguentine in a 
series of twenty-five cases suffering from ca- 
tarrh of the nose and throat and in cases in 
which there was considerable discharge from 
the nose (hypertrophic rhinitis) and also 
where there were hard scales of inflamed 
areas developed. In every case, Unguentine 
proved of great value, affording prompt relief 
and, when used in conjunction with proper 
cleansing antiseptics by atomizer or nasal 
douche, never failed to give excellent results. 

+ 
Clinical Experience a Dependable Guide. 

Countless physicians the country over have 
proven to their entire satisfaction that Gray's 
Glycerine Tonic Comp. fills an indispensable 
place in the treatment of all diseases in which 
lessened vitality is a prominent feature. Tt 
represents one of the notable advances in 
modern pharmacy, and many a practitioner 
has learned to rely upon it as his most valu- 
able aid in increasing functional activity. 
Gray*s Glycerine Tonic Comp. exerts an es- 
pecially beneficial influence on the gastric 
and intestinal glands, thus stimulating the ap- 
petite, improving digestion and promoting 

assimilation. 



Cheap, but Unsurpassed. 

On account of the unreliability of the aver- 
age fever thermometer, as sold by small drug- 
gists throughout the country, the Max Woch- 
er & Son Company, of Cincinnati, have placed 
the Imperial grade on the market, which line 
of thermometers are thoroughly seasoned 
about twelve months before the tubes are 
calibrated, and each thermometer is tested, 
and these thermometers can be depended upon 
as reliable instruments. On account of the 
great sale this firm has on these instruments 
they have been enabled to reduce the price to 
hospitals who purchase the same in dozen or 
gross lots to a very low figure. 

+ 

Sturm Signal System. 
The large increase in the number of hos- 
pitals makes it imperative that a method of 
signalling be used which is less expensive in 
operation than the present antiquated and 
noisy system. 
The Sturm Signal System is 
Simple in construction 
Quiet at all times 
Positive in operation 
Direct in results 
Economical in maintenance 
Fully guaranteed 
List of buildings equipped furnished upon 
application. Relay Signal Company, 86 La 
Salle Street, Chicago. 

+ 
Something New. 

The Welkom Warmer is a wonderful new 
device which has recently been put on the 
market and is attracting the attention of the 
medical profession and hospital authorities 
as the only modern, sensible and effective 
substitute for the hot water bag. It is heated 
within one minute by simply lighting and in- 
serting a tube of blazeless, smokeless and 
odorless fuel lasting over two hours at a 
cost of less than one cent. As there is no 
water required in the use of the Welkom 
Warmer the necessity of making a fire and 
waiting for the kettle to boil is entirely 
obviated. Every nurse should write to the 
Welkom Warmer Manufacturing Company, 
108 Fulton Street, New York City, for a 
free descriptive booklet, which thxxroughly ex- 
plains the merits of this new sick room 
necessity. 



ADVERTISEMENTS 



20 Mule TEAMt:;PRODucTS 

F«r the ll«fnry and SIck-llooH 



BORAX is one of the mildest antiseptics 
ioiown; in fact it is comparatively the 
only one known that is wholly safe to use 
in the sick room. Therefore, it caji be used 
in the place of more powerful antiseptics, 
which are frequently the cause of poisoning 
a patient. 

Borax can be used indiscriminately in the 
sick room for softening water with which to 
bathe the patient, and for thoroughly cleans- 
ing bed linen, soiled garments and utensils. 

A boric add solution is cooling and soothing 
for the eyes, for inflamed cuticle or the mu- 
cous membrane. Boric acid spangles are the 
best to use for making a solution. Boric acid 
in a powdered form is unsurpassed as a dust- 
ing powder. 

20 Kuls Taatn Borax. Borlo AaU anil Sp&n- 
IlM ara all pMiJtvd In convkolant cartons for 
tbt nuisa to handla. The 20 Uul* Team 
Brand to alwaya a guarantee of purity. 

WHt# tor our -MUtete Cnwtsr tc«kUt~-fra» 



PACIFIC COAST BORAX CO. 

Naw York : i Chicago i : Oakland 



Help Wanted? 

Would a oaiet, efficient and unobtrusive assistant be accept- 
able to yon daring the long, nerre-tryiiig honrsof duty— an assist- 
ant that would relieve you of one-half the routine part of yonr 

The R.R.R. helps for nurses will render yoa just such assist- 
ance — ever^ one is a specialist in its own particular field, meeting 
every requirement of modem nursing. 

One of these helps is shown in this advertisement — 

The R. R. R. Thermometer Set — Mouth, 
Rectal and Bath Thermometers 

In a Combination Caa* 



replacing broken thermometers. 

The R.R.R. helps also include charts for every purpose — bed- 
aide, maternity and T. P. & R.— and the READY REFERENCE 
REGISTER, the history of your own personal experiences. 

You are entitled to a free and complete set of samples of these 
"Silent Sick-room Assistants;'' to get them just write "Please 
send samples of the R-R.R." over your mune and address on a 
postaL Address the postal to 

THE READY REFERENCE REGISTER 

McTMld BullcHns WATERTOWN. N. ¥. 

When Tou write AdverdBers, pleaae mention Thi Tuinbd Nobsi. 



206 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Typhoid Fever. 

In the treatment of this disease it is neces- 
sary to control the patient's temperature and 
to keep the alimentary canal in as nearly 
aseptic condition as possible. The effort of 
the physician must, however, be directed 
toward preventing intestinal perforation. ' No 
other remedy will accomplish this so readily 
or more satisfactorily than DanieFs Passiflora 
Incarnata. 

Signed, Wm. A. Donovan, M. D. 

+ 
A Cheap Hospital Bed. 

The Wallace Adjustable Hospital and In- 
valid Bed is giving excellent satisfaction to 
its many users. Hospitals can readily procure 
from $3.50 to $6.00 per week additional for 
rooms equipped with it. It not only gives a 
great amount of comfort to the sick and in- 
jured, but saves so much labor in nursing that 
it is practically indispensable. The middle 
section drops for use of bed pan and douche; 
no lifting or moving of patient necessary. 
Write for special prices to hospitals, physi- 
cians and nurses. See advertisement in this 
issue. ^ 

Borax is IHarmiees. 

Dr. Harvey W. Wiley, Chief of the Bureau of 
Chemistry, conducted a series of experiments 
to determine the effect of Bcfron Compounds 
on the human system. He administered borax 
and boric acid to the members of the experi- 
mental squad in capsules. In the report of 
"The Influence of Borax and Boric Acid on 
Health" he says: "It is, nevertheless, an in- 
teresting fact to note that at the end of the 
year, after the final 'after period' had been 
passed, they appeared to be, and declared them- 
selves to be, in better physical condition than 
when they entered upon the experimental work 
seven months before." 

+ 
Ergoapiol (Smith). 

Medical men frequently encounter cases 
where, from one cause or another, the men- 
strual function has abnormally lessened or 
ceased entirely, giving rise to a distressed 
mental state in what is probably a nervous 
and excitable patient. Fears of impending 
evil once aroused cause an aggravated degree 
of mental distress, which is most decidedly 
not beneficial to the patient's welfare, and a 
medicament such as Ergoapiol (Smith), which 
invigorates the reproductive and sexual sys- 



tem, is welcome to the much-harassed profes- 
sional man in search of a preparation which 
is simple and easy to administer. 

+ 
Usee for Cold Cream. 

How many nurses have tried using cold 
cream to relieve chafing or for soothing the 
skin where it has been rubbed and irritated 
by contact with the sheet when a bed-patient 
is restless? Also for rubbing the back after 
using alcohol to prevent bed sores, and for 
keeping the hands and feet of fever patients 
soft when the constant fever makes the skin 
hard and dry? 

Daggett & Ramsdall, 314 West 14th Street, 
New York City, make a perfect cold cream, 
and any nurse sending her name and address 
will receive a liberal sample. 

+ 
The Diet After Abdominal Operations. 

Paterson says that there is still a lingering 
super stitution that patients must be half- 
starved after an abdominal operation. 

As soon as the patient wishes a drink, 
small quantities of hot water are given, and 
if this is retained one ounce doses of milk 
diluted with two parts of water. The quantity 
is gradually increased up to two ounces 
hourly. On the day after the operation, Ben- 
ger's Food and calves' feet jelly are given 
as well as milk. As soon as the bowels have 
been opened the patient is allowed fluid ad 
libitum, eggs, thin bread and butter, and other 
soft solids, and usually ordinary diet is re- 
sumed in a week or ten days. 

+ 
You Should Know This. 

The United States Chemical Company, with 
laboratories in New York and Chicago, have 
decided to market their goods direct to nurses 
and hospitals. 

The United States Chemical Company, one 
of the largest producers of antiseptics and 
disinfectants in the United States, are manu- 
facturers of a standard line of disinfectants. 
Dr. Carl L. Barnes, president of this com- 
pany, has for over twenty years given spe- 
cial attention to the subject of disinfection 
and disinfectants. During the yellow fever 
epidemic, Dr. Barnes was the sanitary officer 
in the city of Chicago, and this Company, 
under his direction, has grown to be one of 

the largest in the field. 
See advertisement in this issue. 



ADVERTISEMENTS 



AN IDEAL HOSPITAL BED. Intum lul rot for padoit udsaves 75% 
of labor in nuning. InKandy and eacily adjuHed to practically evciy posi- 
tion obtainaUe on an operating taUe, without liHing or ntoving patient. Middle lec- 
tion lowers for lue of bed pan or douche. Endoned by Phyiiciaiti and Nunes. Sim- 
plifies bathing and changing of bed linen. Prevents bed sores. It is invaluable for 
Obstetrical cases. An ideal fracture bed; fractures once set give surge<Hi no worry. 
The addibonal hei^t facilitates handling of patients. 

The Wallace Bed soon pays for itself in the increased enlarges obtained for 
rent of rooms furnished with it. Many hospitals and sanitariums are not only roalL- 
ing a reputation for efficiency and up-to-dateness by using this bed, but are also 
making big money out of it. Why not you? 

Our bed is made entirely of metal, indestructiUe, Japan and while enamel 
finish. Shipped complete with easy box springs and fine toft felt mattress, the tame 
day order is received. Special discounts to Physicians, Nurses and Hospitals. 



Whan you wi1t« Advsrtisera, jdeaas msntton Tu TaumD Nuaa^ 



Cbe ^t^Mer'si Besift 



Ct)e CaCneti puttie mt 

A Monthly Magaziiie Devoted to Trained NmtiBg m 
Private Practice and in the Hospitak of the Covat^ 

Editor 

ANNETTE SUMNER KCZL 

LAKESIDE PUBLISHING COMPANY 

PUBUSHERS 
OmCE— 114-116 E«it 28A SufNew YoA Gty 

THE TRAINED NURSE 

hat no free circulation. Its price b $2.00 a year, and 
it is worth IL It is pabliihed in the interest of the 
profession, screens no swindlers, puffs no humbugs, 
and does not take half ttispace to teO how good the 
other half is. 

Annual Subscription, post-paid r .$2.00 

Single Copies .20 

BmUrtd at ucond-clatt matttr mi ikt Ntw York Pcsi 
OMctt March M4ih^ MQOi* 

IMPORTANT NOTICE.— Those of our sutMcrib- 
ers who Mrish to notify change of address must send 
•udh notification in order that it may reach the pub- 
tisbers not later than the 20th of tho month befora 
publishing; o therwise the change cannot be made. 

COMPLAINTS for non-receipt of copies or requests 
for extra numbers must be received on or before 
die lOdi of the month of publication; otherwise 
die supply is apt to be exhausted. 

TO CONTRIBUTORS.— We pay liberally for. all 
Original Articles. 

Exclusive publication must be msured to all 
contributions offered to the Editors. Rejected man- 
uscripts win be returned if stamps be sent for thn 
purpose. 

Exclusive publication not required for contribu- 
tions to Nursing World Department 

Illustrations for articles are particidarly soUciled. 
All expense for drawing plates, etc., will be borne 
by the publishers. 

No responsibility is accepted by the Elditors or pub- 
Eshers for the opinions of contributors, nor are they 
responsible for any other than editorial statements. 

Books and monographs will be reviewed promptly. 

Short, practical notes upon personal experiences 
or brief reports of interesting cases, widi results 
from remedies, new or old, will be welcomed. 

The Editors and printen will gready appreciate 
the courtesy of having all manuscript typewritten; 
or, if this is impossible, clearly written, great atten- 
tion being given to proper names and medical terms. 

Copyriiht. 1910. by Lakasida Pdbttliing Com^mf, 



\ Book Review (Continued). 

Prescription Writing and Formulary. By 
John M. Swan, M. D., Associate Professor of 
Clinical Medicine, Medico-Chirurgical College 
of Philadelphia. 32mo of 185 pages. 1910. 
Flexible leather, $1.25 net. For sale by the 
Lakeside Publishing Company. 

This book is designed especially for physi- 
cians, and the author expresses the hope that 
it may result in a diminution of the number 
of errors in the form of prescriptions, of the 
inaccuracies of doses, and that pharmacopial 
preparation may be found more advantageous 
than substances of unknown composition, al- 
though of elegant appearance. The greater 
part of the book is taken up with formulae 
for the treatment of different diseases, ar- 
ranged in alphabetical order. 



We beg to acknowledge: 

Public Health. The Bulletin published 
quarterly by the State Department of Michi- 
gan. 

The Gouly State, a compilation of ab- 
stracts from recent literature on this subject. 
By W. J. Morrison, price 25 cents. 

The State and the Death-Roll, by E. R 
Rittenhouse, president Provident Savings Life 
Assurance Society, of New York. 

+ 
Please Observe! 

Have you noted the many new advertise- 
ments in the want columns this month? If 
not, we suggest that it would pay you to read 
that department. Some of the advertisements 
are official announcements. 

While you are about it, it might be worth 
while to look over the two premium pages. 
Two new books have been added, and the list 
has Ibeen corrected, including several new 
editions of older works. 

And, by the way, we hope you have not 
neglected to read the prize offer page. If so, 
you are really missing something worth while. 

Lastly, if you are a modern up-to-date 
nurse, by which we mean one who appreciates 
advertising and knows that the advertising 
pages are a valuable part of this magazine, 
we call your attention to the many new adver- 
tisements in this issue. 






VOL. XLV. 



NEW YORK, OCTOBER, 1910. 



NO. 4 



PEARCE BAILEY, M.D., 
Physician to the Neurolofiloal Inetltute of New York, 



THERE is something mysterious and 
solemn when a company of young 
people, having completed the prepara- 
tions of their life work, meet together 
for the last time. Every year such meet- 
ings take place all over the world, and 
then the band of union is broken and 
the individuals scatter, never to be a 
complete company again, but to go to all 
parts of the earth to carry the seed of 
their education and to plant it and 
thereby to become the active distribut- 
ing agents of what our civilization and 
our progress has found to be best worth 
preserving and cultivating. 

I do not know whether the com- 
mencement season falls in the spring by 
accident or design. But it is a fitting 
symbol that those who are to replace the 
old with the vigor of youth and the 
freshness of newly acquired knowledge 
should go to their places in the general 
scheme of things at the same time that 
nature has chosen for rebirth. 

The profession you have chosen is ont 
of the oldest in the world. As long as 
there have been people who are ill there 



have been some willing and anxious to 
take care of them. The earliest au- 
thentic records which we have of a medi- 
cine which approaches in any way the 
medicine of our times comes from Hip- 
pocrates. But if you will read the writ- 
ings of Hippocrates you will find fewer 
facts in them than is taught in the train- 
ing schools today. He had less oppor- 
tunity to learn anatomy than you have; 
he knew less about drugs than you do; 
and if this father of medicine were to- 
day to come back to earth and present 
himself for examination with the pur- 
pose of becoming a registered nurse, I 
fear very much that his name would not 
be among the list of graduates. 

In the days of Hippocrates, and for 
long afterward, medicine was closely 
linked with religion, and during the Mid- 
dle Ages nursing was largely in charge 
of the religious orders. Vestiges are 
still seen of this in the various orders of 
sisters and in some Catholic countries 
like France, where nearly all the nurses 
were, until very recently, Sisters of 
Charity, and even in our own country to- 



^Addrees delivered to the graduatlngr class of the Cocbran Training School for Nurses of St. 
John's Riverside Hospital, Tonkers, N. Y., on June 15, 1910. 



210 



THE TRAINED NURSE AND HOSPITAL REVIEW 



day, in the Roman Catholic hospitals, 
such as St. Francis', the nurses are Sis- 
ters of Charity. 

I am loth to believe that nursing has 
lost the motives of charity which gave 
it birth, but it has none the less be- 
come a definite and legitimate means of 
livelihood as the profession of medicine 
always has been. 

With the broadening tendencies of or- 
ganization it is now one of the most im- 
portant, if not the most important, va- 
riety of woman labor. The recent con- 
vention of trained nurses held in New 
York packed one of Columbia's largest 
halls with alert women from all over 
the country. To-day the trained nurse 
has many opportunities to specialize. 
In addition to being the private nurse, 
who supports herself and often most of 
her relatives, she may, if she likes, be a 
missionary, a district worker, hourly 
nurse, a teacher, a craftsman and a con- 
structive organizer. 

The latter feature is rapidly becoming 
of great importance. With the steady 
growth of hospitals in this country calls 
for competent organizers of hospitals, 
training schools and superintendents of 
nurses are becoming more and more 
urgent. It is also one of the best paid 
professions for women. Trained nurses 
as a class receive higher compensation 
than any other variety of woman work- 
ers. In addition to the salaries, the 
nurse gets very material advantages in 
these days of high food prices. She 
also has opportunities to travel and to 
profit by valuable acquaintances. 

While trained nursing as a modern pro- 
fession took its birth in England, it has 
reached its highest development, like so 
many other things, in America. Our 
training schools and the women they 
produce are unequaled anywhere. They 



are appreciated at home and abroad. 
The American resident of foreign cities 
insist on having American nurses to take 
care of them when they are ill, and 
nurses are well represented in every 
transatlantic passenger list. 

But I sometimes wbnder if, by oui 
very excellence, by our production of the 
perfected craftsman which the modem 
trained nurse is, with her knowledge of 
diatetics, of chemistry, trained as she is 
in regularity and discipline, familiar as 
she is with the technical details of so 
many diseases, whether we do not get 
away perhaps a little too far from cer- 
tain features which are human, rather 
than professional, whether the nurse has 
not become perhaps too much of a nurse, 
and is thereby in danger of losing some 
of the charm and the power which she 
has as a woman ? 

This question arises in my mind, not 
from my experience as a physician, but 
as an outsider; not from professional 
contact, but from the experience of ewery 
one who has friends who fall ill, and 
who cannot be happy until everything is 
done for their comfort and until thev 
are well again. 

One of the worst nurses I ever knew 
is a woman who I think I would rather 
have about me in illness than any one I 
ever met. She is a short, plump, round- 
faced Irish woman who, by some means 
or other, got a diploma from a large 
London hospital. She would write her 
orders on her apron, and, as she changed 
these twice a day, when it came to look 
up the doctor^s orders, they were gener- 
ally in the wash. She was forgetful, and 
your superintendent would call her in- 
competent, as she was ignorant of manv 
of the things which, I am sure, all the 
present class know. But at the same 
time she so invariably looked on the 



THE SUPER-NURSE 



211 



bright side of things, her laugh was so 
spontaneous and contagious, her rosy 
.cheeks beamed out health and encour- 
agement and optimism to such a degree 
that she more than made up in the charm 
of her personality what she lacked in the 
knowledge and other qualities which 
every nurse ought to have. 

We all like skill, but some of us like 
other things, too. A friend of mine, a 
lady, was once ill, in Egypt, of some 
painful abnormal trouble of which the 
diagnosis was always in doubt, but her 
mind kept clear throughout the illness. 
It was necessary for her to be moved 
from place to place and to have a nurse 
who could do this. There were no trained 
nurses to be had, and for this purpose 
there was called in a Sudanese warrior. 
He was six feet four in his stocking feet, 
battle-scarred and cross-eyed; he had 
never heard of St. Elizabeth, or St. 
Catherine, or Friederike Fliedner; but 
in his muscles slumbered the strength of 
a Colossus united with the gentleness of 
a chikl. In subsequent illnesses, when this 
lady has had real trained nurses, she 
always goes back to the time when this 
big Egyptian, light-footed and gentle, 
lifted her with ease, fanned her for hours 
with infinite patience and stilled her pain 
by the sweetness of his smile. 

Now, I am not advocating male nurses 
for women patients, or for men patients 
either, for I know very well that women 
have in them a power of making illness 
bearable, which is a development of the 
maternal instinct, and which no man can 
ever acquire. But the question I wish 
to ask is, Whether the peculiar fitness of 
woman, which is a gift of nature, spon- 
taneous and not fed by learning, is in 
danger of being sidetracked a little by 
the technical accomplishments of art? I 
know I am discredited at the outset, and 



that every superintendent will say no. 
But, nevertheless, I want to mention a 
few things which seem to me quite as 
important as holding retractors or testing 
for albumen. 

To know how to read well is one of 
the first. And it is equally important for 
the nurse to know what to choose to 
read for individual patients. I think 
every nurse ought to have a list of books 
which are suitable for different tastes, 
for different ages, for different condi- 
tions of strength of patients, which she 
can recommend from experience. A bad 
choice is often fatal. I am a great aa- 
mirer of Robert Browning, but I had to 
step in and interefere once because a 
nurse insisted on reading every canto 
through of *The Ring and the Book*' to 
one of her patients. The only trained 
nurse I ever had offered to read to me, 
but after a little I found that I got more 
pleasure from watching her read to her- 
self than listening to her read to me. I 
gave her "Tess of the D*Urbervilles,*' 
and, by noting her sighs as she de- 
voured this romance, I could easily fol- 
low poor Tess*s troubles and forget my 
own. 

The training school teaches you how 
to care for very ill people. But the fact is 
that the trained nurse is only a trained 
nurse for about half of the time. A per- 
son with typhoid fever is ill for three 
weeks, and for seven or eight weeks he 
is a weak, irritable, plaintive invalid, 
and during this latter period he must be 
encouraged or diverted, or sometimes 
scolded a bit. It is the same way with 
most other acute diseases. After the 
stormy battle is over the duties of the 
nurse are to repair the ravages, and dur- 
ing this* time more demands are made 
upon her personal qualities than on her 
professional training. And so it is 



212 



THE TRAINED NURSE AND HOSPITAL REVIEW 



throughout the whole career of nurses. 
They are called upon to be children's 
playmates, mothers' helpers,, amusement 
bureaus. They must be able to make a 
room look neat, arrange flowers, answer 
the telephone, and keep the cook froiti 
leaving. Often enough th^y must put up 
"with hardships, though not as many as 
in th« days of Elizabeth Fry, and must 
Tesort to many makeshifts. The best 
nurse I ever knew used to go South 
every year and work several months in 
the families of the poor whites. She 
worked for nothing, but felt herself re- 
paid by what she gained in self-reliance. 

There is no profession in which tact is 
more necessary than in yours. Over and 
over again you will sec things going a 
way in which you think, perhaps, they 
ought not to go. You may see domestic 
differences that you think you might ben- 
efit by interfering. *No rules can be given 
by which a nurse can acquire the happy 
faculty of speaking when necessary or 
keeping quiet when necessary. It is one 
of those God-given gifts which may be 
improved by experience, but which can- 
not be taught. However, I think one 
rule can always apply here as every- 
where else — that it never pays to try to 
patch up differences between a man and 
his wife. 

My experience is that nurses and doc- 
tors always get along well together, but 
sometimes you may see treatments or- 
dered that you think are not right, or 
may come to the conclusion that the phy- 
sician in charge is not as competent as 
he ought to be. I have on a few occa- 
sions seen benefit result when nurses 
openly insisted, through the family, of 
course, on consultations or on changes 
of treatment. This is always very dan- 
gerous, and should only be resorted to 
under exceptional circumstances — not 



for the reason that all physicians arfe 
good or any are infallible, but for the 
reason that a patient's confidence in the 
physician is half the cure, and if this is 
once shaken the result may be more un- 
fortunate than a wrongly ordered treat- 
ment. We all have our ideals of physi- 
cians. Of mine the one I have read of 
is William McClure, of Drumtochty ; the 
one I knew was William Sherman, of 
Yonkers. 

There is another rule, which admits of 
few exceptions, which you may follow, 
and that is to keep your knowledge of 
disease to yourself. Don't talk to your 
patient about preceding cases, or about 
how illness turns out, excepting in so far 
as you can tell him that they always turn 
out well. I recently heard of a doctor 
who told a young girl that he had seen 
hundreds of cases just like hers, and 
none of them got well, and that she need 
harbor no hope of ever getting well. The 
effect on the patient was most disastrous. 
I fear in this case the doctor was right 
in his diagnosis, though wrong in his 
philosophy. But I have known of other 
cases of doctors priding themselves upon 
their frankness with their patients, but in 
which the patients got well, in spite of 
the doctors and in the face of the gloom- 
iest prognosis. Even the wisdom of the 
great god Bud is not perfect, and there 
are few things unalterable in the prac- 
tice of medicine. 

Two years ago I was called to Paris 
to see a patient who, when I got there, 
seemed to me to be in extremis. I 
cheered the patient as well as my own 
gloomy fears would permit, and cabled 
home that "George had three months to 
live." When I was in Paris last winter 
George came to see me, the picture of 
rosy and robust health, and his cordial 
indulgence for my blunder convinced me 



THE SUPER-NURSE 



213 



that all the noble people were not in the 
medical profession. 

It is sometimes difficult, in the face of 
direct questions, to be absolutely truth- 
ful with your patients. It is, however, 
easier for a nurse than it is for a doctor, 
' s the nurse can always answer that she 
does not know, and the doctor must de- 
cide. But, entirely apart from the ques- 
tion of ethics, I am sure the best rule 
to follow is never to deceive your pa- 
tient under any circumstances. Occa- 
sions arise in which this seems very 
difficult and even inadvisable, but in the 
long run you will find that you will gain 
by making it a practice. 

In your position as nurse, you will 
come across many secrets, many skele- 
tons in the closet, many things which you 
either find out yourselves or are told to 
you. All of these must be held abso- 
lutely sacred, as the nurse should be 
bound by the same oath as the physician. 
In the pictures and sculpture of Japan 
one frequently meets the legend of the 
three monkeys. To teach the moral one 
is figured with hands over , ears to 
prevent hearing evil things; another 
with hands over eyes to prevent 
seeing bad sights, and the third 
with hand over mouth, so that no 
ill-judged utterance may issue there- 
from. We cannot avoid seeing and 
hearing evil things. But the third mon- 
key should be a model to us and should 
be added to the goat as a symbol of 
Aesculapius. 

It is a great regret to me that there are 
so few opportunities for nurses to have 
included as a part of their training the 
nursing of nervous diseases. As soon as 
you come out into practice you will find 
that a good proportion of the patients 
that you have to treat belong to the class 
of nervous invalids. But you, com- 



ing fresh from typhoid fever and from 
pneumonia, and from operations, have 
had little experience in the long, tedious 
struggle with this variety of vampire, 
and doubtless will find it dull in com- 
parison with the active life of the wards. 
We have now established in New York a 
hospital for nervous diseases. We re- 
ceive the borderland states between 
sanity and insanity, and we treat a great 
variety of nervous cases in which all tut 
expressions of disordered nervous sys- 
tems come out. 

I cannot too strongly advise any of 
you who have the opportunity to take a 
course of a few months in such a hos- 
pital, and to acquire, before you go into 
private work, the experience with nerv- 
ous patients which is so essential. In 
such wards you will learn how to direct 
the patient's mental attitude, how to 
make him cheerful, how to make him 
look on the bright side of things, and 
take his thoughts away from the gloomy 
side of things. You will do this partly 
by persuasion and partly by directing the 
patient s mind from himself, which are at 
the basis of the form of treatment that 
we hear so much of nowadays — namely, 
psycho-therapy. The nurse should be a 
psycho-therapist a*bove everything else. 
If she is not born with the gift, like the 
bone-setters, she can only learn it by ex- 
perience. Once you become familiar with 
nervous people you can stand with more 
equanimity the fault-finding and irrita- 
bility which are so common in them and 
which are part of every convalescence. 

I can do no better in wishing you god- 
speed in the career you have chosen than 
to urge you to cultivate the spirit of op- 
timism. Hold high the torch of hope for 
yourself and for others. Dr. Truddeau, 
the Adirondack missionary, whom the 
medical profession of America consid- 



214 



THE TRAINED NURSE AND HOSPITAL REVIEW 



ered this year as their most representa- 
tive member, says: "As I look back on 
my medical life, the one thing that seems 
to stand out as having been most helpful 
to me, and which has enabled me more 
than anything else to accomplish what- 
ever I have been able to do, seems to me 
to have been that I was ever possessed 
of a large fund of optimism ; indeed, at 
times optimism was about the only re- 
source I had left with which to face most 



unfavorable conditions and overcome 
serious obstacles." 

And I say encouragement has a higher 
percentage of cures to its credit than 
serum therapy, and cheerfulness has pre- 
vented more disease than antiseptics. 
Optimism is a pride in our accomplish- 
ments which justifies confidence in our 
future. By keeping it constantly with 
us we benefit our own selves, our pa- 
tients and our profession. 



A Letter to Waltham 



A letter written by Florence Nightin- 
gale to the nurses of the Waltham Train- 
ing School: 

London, Dec. 23, 1896. 

Dear Nurses — God bless, you and every 
one. And what does His blessing mean to 
us Nurses? 

Docs it not mean that, as nursing has to 
do with the body, which is the "temple" of 
the Holy Spirit, has to do with life and death 
(not with books), all our work in it must 
"begin, continue and end" in Him? 

I — A good nurse must be a good woman. 

A good woman is one who gives the best 
of a woman, intellectual, moral, practical to 
her patients under the orders of a doctor. 

Not a literary woman. More than one 
doctor has said to me of a nurse: "bhe 
knows as many words as I do, but she does 
not know how to make a patient comfort- 
able." 

Books may do much — classes more— clin- 
ical classes especially. You can learn much 
out of lectures as to the reason of what you 
are doing, why you do this and not that. But 
a nurse is not a lecturer. You may know all 
that and your patients not be the better of you. 

2 — Let us never consider ourselves as fin- 
ished nurses. It takes five years to make a 



good ward "sister" (head nurse). We must 
be learning all our lives. 

3 — Besides, every year we know more of 
the great secrets of nursing — also one conun- 
drum has superseded another. "Gentlemen," 
said a professor of the St. Thomas Hospital, 
now dead, to his Students, "disinfectants are 
of the utmost importance — they make such 
an abominable stink as to compel you to open 
the window." 

The aseptic has superseded much. A great 
doctor, a friend of mine, said: "Call it gerips, 
bacillus or dirt, what you will, the treatment 
is the same," i. e., cleanliness. The aseptic 
means absolute cleanliness. 

4 — Let us not treat nursing as a sacrifice, 
but as the great delight of life. 

5 — Would you offer less than a perfect nurs- 
ing to God? 

6 — Let us make nursing less a matter of 
business and more of a calling. It is a noble 
calling, but we must make it so. 

Do you agree that this is what His blessing 
means to us nurses? F. N. 

Your beloved and admirable superintendent 
asked me to write you. May we all take 
example by her. F. N. 

From a fac-simile letter published in the 
report of the twenty-fifth anniversary of the 
Waltham Training School. 



a :feto i^eMong iProm tje i.i!e of :f lorente 

^tgt)ttngale 

CHARLOTTE MANDEVILLE PERRY, 
Superintendent Grace Hospital, New Haven, Conn. 



^nrZHEN reviewing the lives of great 
^^ characters it is well to gather 
up, in order that we may imitate those 
noble qualities of mind and heart which 
inspire us with so much enthusiasm. 
Otherwise such examples are lost ; for us 
they have lived in vain. It was what 
Florence Nightingale was in herself at 
the time of her supreme effort which 
enabled her to do what she did. From 
childhood up, with a most natural de- 
velopment in the midst of a rarely 
beautiful home, she seems to have been 
fitted, as few are, for the exercise of 
that far-reaching influence which culmi- 
nated in a special work at a crisis of the 
world's history. From that highest point 
there reflects a glorious light over the 
successive years of her life — a light 
which will leave a glow even though 
she has passed from sight. 

How much she has said about the 
preparation for our life-work, if we wish 
to make "God's business succeed." Just 
that expression, "God's business," speaks 
of the deep religious foundation which 
she thought so necessary a part of our 
equipment. Was it not needed in facing 
the degradation of the nursing and of 
the hospitals of the period? Is it not 
ever needed if we are to keep the pro- 
fession thus raised up to a high levd? 
That her religion was not mere sentiment 
is abundantly proved by her writing so 
frequently, so insistently upon the neces- 
sity of technical training in nursing and 
business detail, as well as by her having 



founded the first training school as a 
means to securing these ends. 

In the character of Florence Nightin- 
gale there are certain qualities which 
stand out clear and strong from earliest 
years. First of all, there was that 
true sympathy for suffering, whether in 
man or animal, which expressed itself in 
action for the relief of the sufferer, and 
an inner spirit of hopefulness regarding 
the success of her endeavors for the pa- 
tient and his power to respond, which 
not only reacted upon the patient, but 
nerved her own arm; there was an in- 
domitable perseverance and fortitude, all 
of which produce an ideal nursing char- 
acter. However, one can fancy all these 
traits without including that calmness, 
self-control, gentleness, combined with 
courage of conviction, clear vision, de- 
cisive action, and that retiring nature 
which studiously avoided all publicity 
which she possessed to so remarkable a 
degree. 

"Gentle ways and polite manners help 
greatly to further the kingdom of God," 
said Pastor Fliedner when Florence 
Nightingale presented herself at Kaiser- 
worth for the training she had advo- 
cated. She would not have recom- 
mended to others what she would not 
herself undertake. As she stood face to 
face with her appalling task of improv- 
ing the nursing and the hospitals of that 
time, she viewed a condition inconceiv- 
able to members of the profession to-day. 
Her power of application, of so shaping 



216 



THE TRAINED NURSE AND HOSPITAL REVIEW 



her work as to bring about most quickly 
the needed reform; her freedom from 
religious bigotry and from a harmful ag- 
gressiveness, whereby unnecessary an- 
tagonism might have been provoked ; her 
real love for the poor and for the suf- 
ferer, whoever he might be; the atten- 
tion given to hygiene from the first start- 
ing out; her visits to the hospitals of her 
own and different countries through 
which she gained an actual, comparative 
knowledge of them opened to her the 
various avenues in which her influence 
spent itself with such universal profit. 
For all branches of nursing — in hospital 
or private home, for army and visiting 
nursing and social work she laid funda- 
mental rules with a heart in them. Her 
work was in advance of the time. She 
pointed out principles like that of nurses 
learning to nurse "in a hospital"; of the 
affiliation of schools, as in the establish- 
ing of a course for the training of visit- 
ing nurses at the Liverpool School and 
Home for Nurses; of placing graduate 
nurses in charge of charitable institu- 
tions as matron, and of forming organi- 
zations for providing nurses for those 
unable to pay. Through the last men- 
tioned it was found that nurses sent out 
in this way accomplished the best kind of 
social work by preventing "indiscrimi- 
nate charity, by teaching patients how 
best to help themselves, and by showing 
them ways of stopping the cause of dis- 
ease and the cause of infection which 
spread disease." 

Her marked success was well won, 
and largely due to her diligence, to that 
good English perseverance which falls at 
one's post rather than give up, or allow 
oneself to be beaten. But most of all 
was it due to her large heart, to that 
tender concern for suffering which would 
not permit her to rest till something had 



been done to bring the desired help. She 
has rightly been called the "soldier's 
friend," the "patient's friend." In 
reading her life one cannot l)ut be im- 
pressed also with the absence of an ob- 
truding personality. She was womanly 
and wished to keep within woman's 
sphere, though ready to do anything and 
everything for the furtherance of "God's 
kingdom." In this way she had the con- 
fidence and co-operation not only of the 
doctors, but of army officers, so that 
they even sought her advice as possess- 
ing a superior knowledge and judgment 
in matters relating to sanitation and hy- 
giene, to reconstruction and reform. As 
a result, vast reforms were effected in 
the English army, especially in India. 
Like Dorothea Dix, she has possessed 
that persuasiveness which appeals not 
only to the heart, but to the head, and a 
great deal of what she has accomplished 
is owing to her ability to make others 
see the need and others again to help 
themselves. Her humanitarian views 
were sound and effectual in stirring 
those springs of effort on which every 
individual soul depends for success or 
for reformation. Do we not well sit at 
the feet of the Queen of Nurses and 
learn wisdom? 

Now that so many spheres of useful- 
ness are opening for women, there is 
much which can profitably bring into play 
these noble characteristics. There is real 
danger of true proportions being lost, es- 
pecially if personal interests are allowed 
to creep in, and unnecessary prejudices 
like little foxes destroy the vines. This 
last thought reminds us of that largeness 
of purpose, tempered with wisdom, which 
preserved the good while it lopped oflF 
the injurious things. The supreme test 
was at Scutari, where those in office 
were blameworthy for the most awful 



THE LIFE OF FLORENCE NIGHTINGALE 



217 



state of affairs in the barracks-hospital — 
a human pen, with even food denied. 
Yet not an officer but recognized that she 
respected his office while denouncing the 
wrong with no uncertain voice. It was 
by persistent effort and appeals that 
needs were finally met. Soon all were 



pulling together, doctors and nurses sac- 
rificing their lives in the common cause. 
"United we stand, divided we fall." As 
tfie warning note sounds, let selfish ambi- 
tion in all its forms flee away, that the 
bad may be forgotten, while the good is 
remembered. 



An Interview with Miss Nightin8:ale 

In his address delivered at the twenty- 
fifth anniversary celebration of the VVal- 
tham Training School for Nurses, Dr. 
Worcester gave the following account of 
an interview with Miss Florence Night- 
ingale. When he first asked for an in- 
terview Miss Nightingale referred him 
to others, but eventually consented to 
his coming. 

"If," as she wrote, "there was anything to 
be learned by our talking together." 

Dr. Worcester says: "I shall never forget 
Miss Nightingale's graciousness. She kept 
asking me questions about this training school. 
I wanted to ask her questions, but could 
hardly get one in edgewise — hers came so fast : 
How much time did we spend in this, how 
much in that and the other thing, and what 
were we really trying to do? Finally, when 
I did get in a few of my questions as what she 
would advise us to do here and what model 
she would advise us to follow, she told me 
at once where to go, and urged me to study 
and copy one particular small school in Lon- 
don, where, as I afterward found, the pupil 
nurses, before being sent to the hospitals for 
one year's training, were first tried out, as it 
were, in work with district visiting nurses, and 
then, after their hospital year, were given the 
rest of their training in the homes of their 
patients. She told me of her disappointment 
rn the development of the hospital training 
schools, which, she said, were making scientific 
nurses technically admirable but without the 
needed love for the art of helping the help- 
less. When, on leaving, I asked her if she 



would let me send our superintendent to her, 
she promised her heartiest assistance, which 
promise she most beautifully fulfilled." 

+ 

Extract from Letter 

Extracts from some hitherto unpub- 
lished letters written by Miss Florence 
Nightingale have recently appeared in a 
number of the Christian Commonwealth, 
London. These letters were addressed 
to Surgeon James Pattison Walker, in 
India, and were written between nine 
and twelve years after Miss Nightin- 
gale's return from the Crimea. One of 
the most interesting extracts was written 
on Aug. lo, 1868, and is as follows: 

"It is also eleven years this very day since 
I was taken ill with the illness from which 
I have never risen again. You see how much 
I have to thank God for, who has indeed led 
me by a way which I have not known. At 
the same time He has seen fit to send me 
troubles and trials, like waters which one could 
not cross, were one to look down into them. 
I am almost the last survivor of my fellow 
workers in England, men, some of them, but 
little older than I. And this very year has 
seen the death of the best and dearest of my 
pupils, my 'Una,* who was many years younger 
than I. 

"Life, under this discipline, loses — shall I 
say? — or gains all its value. It becomes but 
as a part of eternity. And past and future 
would seem almost more a reality and a pres- 
ence than the present were it not for pressing 
duty." 



Ciie ;f ountier of ^ur ^tofesidton 



WINOGENE PENNEY. 



ONE May day in the year 1820, in 
Italy, near the city of Florence, 
a little English baby first saw the light. 
It was Florence Nightingale. Little did 
her gentle mother think of the baby's 
name becoming a household word 
throughout the whole civilized world. 

Florence Nightingale's home was in 
England, and there she grew into girl- 
hood and womanhood. Her father was 
an educated and wealthy man, and 
neither time nor money were spared in 
giving the little Florence the best of edu- 
cational advantages. She was a sweet, 
simple child, with a heart full of love 
and tenderness for all creatures, espe- 
cially men and women and little children 
who were poor and unable to care for 
themselves. 

She spent her young womanhood in 
studying hospital conditions at home and 
abroad. The comparison was not favor- 
able; the nursing in England's hospitals 
was in the hands of the coarsest type of 
women, not only untrained, but cal- 
loused in feeling, and often grossly im- 
moral. The characters which Dickens 
describes in his works as "Sairy Gamp" 
and *'Betsy Prig" are not caricatures of 
a wild fancy, but persons who actually 
lived and put the stamp of contempt and 
ridicule upon the vocation of nursing. 

In contrast to this repulsive set of 
women whom Miss Nightingale encoun- 
tered she found on the Continent the 
sweet- faced Sister of Charity — pious, ed- 
ucated, and trained. For centuries the 
Roman Catholic community had trained 
and set apart holy women for minister- 
ing to the sick poor in their homes, and 



had established hospitals supplied with 
the same type of nurse. A large number 
of these women were ladies of birth and 
culture, who worked for the welfare of 
their church, while all received proper 
education and training. 

After Miss Nightingale's investigation 
through many hospitals she decided to 
take a course of training at a recently 
founded institution for deaconesses at 
Kaiserswerth on the Rhine. There a 
Protestant sisterhood were working on 
lines similar to those of tlie Sisters of 
Charity. 

Theodore Fliedener, a German pastor, 
was the founder of this new institution. 
It was no easy task. He met with all 
sorts of difficulties, and the beginning 
was exceedingly small, but he never 
groped in the dark, his steps were sure. 

Who can imagine the flutter of ex- 
citement at Kaiserswerth among the 
good peasant deaconesses as they flut- 
tered about in their simple blue cotton 
gowns, white aprons, and trim muslin 
caps, when it was known that an Eng* 
lish woman of wealth and position had 
come to stay among them ! That such a 
woman should voluntarily undertake the 
duties of a hospital nurse, tending the 
poor sick with her own delicate hands, 
was at that time almost unprecedented. 
Miss Nightingale was quickly at home 
among her fellow-nurses, for she had 
a passion for hard work and a wealth of 
good common sense. 

All too soon to both patients and 
nurses, her training months came to an 
end, and with the pastor's benediction, 
her great powers being dedicated to the 



THE FOUNDER OF OUR PROFESSION 



219 



service of humanity, s*he went out from 
Kaiserswertli. 

It was these two, the English gentle- 
woman and the German pastor, who 
successfully demonstrated to the civil- 
ized world its need for trained nurses. 
Modern nursing owes its origin to them, 
not to the medical profession, though it 
has been fostered by the combined ef- 
forts of pioneer nurses, physicians, and 
laity. 

It was the Crimean War that brought 
to Miss Nightingale her hour to serve 
humanity most effectually. We will not 
try to picture the ghastly conquests and 
the terrible conditions and the almost 
unbearable suffering endured by the offi- 
cers and men alike, but rather how 
Florence Nightingale, with her thirty- 
eight nurses, brought order and calm 
and good food and cleanliness to the 
thousands of soldiers out of the most 
indescribable chaos. 

When the Crimean War had passed 
into history Miss Nightingale's heart was 
full of thankfulness that she might re- 
turn to England. Her mind was very 
busy, for she coveted the best of things 
for the English nurses, and she wanted 
to help to raise the system of nursing 
to a degree of efficiency never before 
known. How great was her disappoint- 
ment when she found her health was all 
but gone, and she would never again be 
able to enter her old active life. Yet not 
a day passed unoccupied. She was look- 
ing after the instruction of nurses in 
several hospitals. People all over Eng- 
land and Europe and our own America 
were writing to her for ■ advice about 
hospitals and training schools, and 
freely and gracefully she gave, and al- 
ways the help most needed. 

The modern nurse is the result of a 
gradual evolution. It took time and work 



and faithfulness for nursing to become 
recognized as a useful and even elevat- 
ing vocation. 

Miss Nightingale coveted the best 
women as probationers in the training 
schools. She said: "The commonly re- 
ceived idea among men, and even women 
themselves, that it required nothing but 
a disappointment in love, the want of an 
object, a general disgust, or an incapac- 
ity for other things to turn a woman 
into a good nurse, is like unto the parish 
where a stupid old man was set to be 
schoolmaster because he was past keep- 
ing pigs.'' 

Miss Nightingale gave to nurses the 
highest ideals to strive for. She said : 
"Nursing is no holiday pastime. Nursing 
is an art; and to be made an art, it re- 
quires as exclusive devotion, as hard a 
preparation as any painter's or sculpt- 
or's work, for what is the having to do 
with dead canvas or cold marble com- 
pared with having to do with the living 
body — the temple of God's Spirit? It is 
one of the fine arts — I had almost said 
the finest of fine arts." 

The profession of nursing is one in 
which every woman should be worthy 
of her vocation. It means an earnest, 
careful making ready for duty, and then 
a faithfulness to duty. As nurses we do 
not spend our years in training for the 
financial remuneration that may come, 
but that we may be more efficient "to 
serve whomever whenever we can." 

We should never lose sight of Miss 
Nightingale's ideal for us, we should 
never forget our Alma Mater's careful 
training and instructions, and we should 
always remember the Lord Jesus com- 
missioning us to duty for His sake — 
Inasmuch as ye have done it unto the 
least of these my brethren, ye have done 
it unto me. , 



0iiik i^tattonfii 



ANNETTE FISK. 



/^NE of the popular philanthropies at 
^^ present, especially during the sum- 
mer months, is the distribution of pure 
milk, both plain and modified, at rea- 
sonable prices, for the babies of those 
in poor circumstances. Five years ago 
such work was comparatively rare, but 
it has been spreading of late, and this 
summer milk stations have been started 
in many cities in Massachusetts, as in 
Lowell, Springfield, Worcester, to say 
nothing of other states. Although in 
general the plan is the same everywhere, 
there are still sufficient differences to 
make it interesting perhaps to consider 
two of the more divergent schemes. 

I first became interested in milk sta- 
tion work the summer of 1906, when a 
combination of circumstances led to my 
having charge of the milk distribution 
opened for the first time that summer by 
the city of Cambridge, Mass. The Milk 
Inspector at that time. Dr. A. P. Norris, 
had direct management, and planned it, 
I believe, very largely after the method 
already in operation at Roclrester, N. Y. 
At any rate, the general plan was as fol- 
lows: 

Five stations were opened in different 
parts of the city for the distribution of 
plain and modified milk, the latter being 
prepared at the central station by the 
nurse in charge. The other stations were 
also presided over by trained nurses, ar- 
rangements being made with the Cam- 
bridge Visiting Nursing Association for 
two of their nurses to have charge of 
two stations each for an hour every 
morning. Any one could apply for milk, 
with or without a doctor's order, and 



where there was no order the nurse ob- 
tained the requisite information, weighed 
the baby, and prescribed the formula, the 
weight having much influence in the de- 
termination of the formula. It was also 
expected that the mother should bring 
the baby at least every three weeks to be 
weighed, that it might be clear whether 
or not it was gaining on the food. Each 
mother was given an excellent little 
pamphlet on the care of the baby in hot 
weather, and it was interesting to see 
how eager the mothers were for the most 
part to follow the advice given in it. 
While giving out the milk in the morn- 
ing the nurse had an opportunity to in- 
quire for the babies, and if they became 
sick could see that they had due medical 
attention. This side of the work is be- 
ing emphasized more now, . however, 
than it was the first year or two. 

As it was largely pioneer work, and as 
the appropriation was not a large one 
and all the apparatus had to be pur- 
chased, some ingenuity was required to 
plan effectively and at the same time 
economically. Thus that first year, after 
thorough washing with a brush, all the 
bottles were sterilized, not in a steam 
sterilizer, as now, but by boiling in 
clothes-boilers. These were filled from 
ihe faucet by means of a piece of hose 
and were emptied through faucets set into 
the side near the bottom, a slanting false 
bottom allowing the water to drain out 
of the bottles simultaneously with the 
emptying of the boiler. Later on less 
water was used and dependence put upon 
the steam generated in the boiling. When 
taken out the bottles were set up in 



STERILIZING BOTTLES. 



FILLING BOTTLES. 



222 



THE TRAINED NURSE AND HOSPITAL REVIEW 



trays that held nine bottles one way and 
six the other, and were covered with wet 
sterile cloths until time for filling, when 
nine could be filled at once by means of 
a special filler planned by Dr. Norris. A 
certain amount of evening up was re- 
quired later, to be sure, but that was 
easily and quickly accomplished with a 
patent funnel, holding about a quart, 
with a spring to regulate the outflow. 
Everything was sterilized, of course, ex- 
cept the milk, which was exceptionally 
fine and pure, being obtained from the 
Cedar Hill Farm, one of the few certi- 
fied farms in the neighborhood of Bos- 
ton. Those in charge of the distribution 
believed that clean, unsterilized milk was 
the best food for the infant. The bacte- 
rial count seldom exceeded 2-3000 per 
c. c. 

Cream mixtures were used, four mod- 
ifications being put up. The substances 
used in modifying were water, lime 
water, and milk sugar, and the solu- 
tions of these combined in the right pro- 
portions were prepared and sterilized by 
boiling the night before. In the morning 
about 5 130 the milk came from the farm, 
heavily iced, and the top cream (10 per 
cent, fat) was drawn off. As more such 
light cream was needed, however, than 
could be obtained from the bottom milk 
required, additional heavy cream (40 per 
cent fat) was purchased and reduced by 
the addition of bottom milk. When the 
right amounts of top and bottom milk had 
been added to the solutions they were 
ready for bottling. At first absorbent 
cotton stoppers were used, and then an 
experiment was tried with rubber stop- 
pers, but corks proved most satisfactory 
in the long run. When the bottles were 
all ready they were sorted into water- 
tight, covered boxes and iced, that the 
milk might be kept at a proper tempera- 



ture until delivered to customers at the 
dispensing stations. The prices charged 
were one cent for four ounces or less 
and two cents for anything more than 
that up to eight ounces, in the case of 
the modifications. Whole milk was ten 
cents a quart. This just about covered 
the cost of materials, there being a small 
deficit on the milk sugar. The lime 
water we made ourselves. , 

This good work has been continued in 
Cambridge every summer since and is 
going on now, a sixth station having re- 
cently been opened. I was in charge for 
two summers, but had not since been 
directly in touch with the milk work 
until last December, when I accepted the 
position of Supervising Nurse for the 
ten milk stations run by the Boston Com- 
mittee on Milk and Baby Hygiene. My 
supervising duties, however, did not 
really begin until some time in January, 
and I first spent a week at one of the 
North End stations and then ran the sta- 
tion in Roxbury for some time. Even 
after I began the supervising I had direct 
charge of a small station in Cambridge, 
The methods employed by the committee, 
with whom I severed my connections a 
short time ago, are quite different in 
many ways from those followed by the 
City of Cambridge. The plan is much 
more elaborate and more costly. Wheth- 
er the results differ greatly it is hard to 
judge, as the methods of calculation of 
the two organizations vary. Thus, the 
Milk Inspector in his report of the first 
summer distribution in Cambridge said : 
"The use of this milk last summer bv 
some 250 infants resulted in a decrease 
of 16 per cent, in the city mortality rate 
for infants dying from acute enteric dis- 
turbances," whereas the Committee on 
Milk and Baby Hygiene in their report 
this spring say : "This table proves that 



MILK STATIONS 



223 



within the districts served by our sta- 
tions the death rate during the worst 
months of the year was nearly 33 1-3 
per cent, lower for the one- tenth of the 
babies who were under our care than 
for the nine-tenths who were not." So 
many things have to be taken into con- 
sideration in a comparison of such sta- 
tistics that it is hardly fair to try to draw 
any serious conclusions. 

The Boston committee uses inspected 
instead of certified milk and pasteurizes 
it. This inspected milk, which they claim 
differs from the certified only in that its 
bacterial count may run as high as 50,000 
instead of 10,000 per c. c, is supplied by 
D. Whiting & Sons, at whose laboratory 
in Charlestown the modifications — in this 
case also cream mixtures — are put up. 
The committee has oversight of the spe- 
cial farms from which their milk comes, 
and of the laboratory, and decide what 
formulae shall be used. The prices of 
the milk as sold cover the cost of ser- 
vices as well as of materials used in 
preparation. They are consequently 
higher than in Cambridge, in spite of the 
less expensive milk used. All formulae 
may be obtained in pint bottles at the 
rate of nine cents a quart, while for the 
individual-feeding bottles the prices are 
2, 2 1-2, and 3 cents for 4, 6, and 8 
ounce bottles. It seems a pity that the 
individual- feeding bottles should be so 
^?igh, as in many of the homes it is most 
undesirable to have pint bottles in use, 
as once opened the bottle is liable to 
stand about unstoppered. The cost of 
bottling in the small bottles, however, is 
high. 

At each station, of which there are ten 
in different parts of Boston, a trained 
nurse is in charge. She is not allowed, 
however, to givq out any milk except 
on a doctor's order. If a baby comes 



without an order and the mother is un- 
willing or unable to go to a doctor for 
one, the nurse can give the formula she 
thinks best until the next consultation, 
but the child must come then for the 
doctor to decide about its food. For at 
least one, and often two or three confer- 
ences or consultations are held at each 
station every week, at which a doctor is 
present and to which the mothers bring 
their babies to be weighed and to report 
progress. Neither doctor nor nur*-c is 
supposed to treat sick babies, for the 
work is wholly a preventive one, the 
idea being to keep the babies well. When 
they get sick they are supposed to be 
turned over to their own family phy- 
sician or to some hospital or dispensary 
or to the district doctor, until such time 
as they are well. If a nurse's care is 
needed the district nurse is called in. 
Ordinarily, however, the station nurse is 
required to visit at least once a week 
each baby taking milk at her station or 
coming to conference. If it seems desir- 
able she goes oftener. On such a visit 
she learns how the baby is and tries to 
find out whether the mother is carrying 
out the doctor's orders. It is a matter of 
educating the mothers in infant hygiene, 
in the best way to feed, clothe and gen- 
erally care for the baby, a very impor- 
tant part of the work. The chief value 
of the conference, it seems to me, is the 
added weight that may come from "doc- 
tor's orders." 

Where the nurse gives all her time to 
the babies and to visiting in the homes 
she can give special attention to the urg- 
ing of breast feeding. Many mothers 
think they have not milk enough, perhaps 
do not have, and either try to fill out 
with modified milk or even change to it 
entirely. In such cases the nurse can 
oftentimes, by advising the mother as to 



( 



224 



THE TRAINED NURSE AND HOSPITAL REVIEW 



her own diet and personal hygiene, make 
even part artificial feeding unnecessary, 
and so greatly benefit the child. Some 
very wonderful results have been ob- 
tained in Boston in the way of building 
up the mother's milk, in one case the per- 
centage of fat being raised from a little 
over I per cent, to over 4 per cent. This 
testing of the mother's milk is a valuable 
aid in judging of breast-fed babies that 
are not doing well. 

While on my vacation this spring I 
spent a week in New York and visited 
some of the milk stations there. Straus's 
laboratory was most interesting, and I 
visited some of the Straus stations also. 
I was told that they use nothing but cer- 
tified milk, but it is all pasteurized. As 
their stations are very numerous — seven 
open all the year and eleven open during 
the summer — they employ their own spe- 
cial doctor at a salary to look out for the 
babies, and he devotes all his time to 
them, holding conferences at the differ- 
ent stations. There are also three nurses 
engaged in visiting in the homes, but 
that seems a very small number of 
nurses to care for so many babies. Some 
cream mixtures but more whole milk 
modifications are used. 

The New York Milk Committee also 
runs four stations, with a nurse in charge 
of each and a supervising nurse in gen- 
eral control. The number of babies at a 
station is restricted to seventy-five, and 
the nurse is supposed to make twenty- 
five calls a week. Very little modified 
milk is sent out from the stations, as the 
committee believes in modification of the 
milk in the home. The nurses, there- 
fore, teach the people to modify the milk 
at home, and only modify it at the sta- 
tion under unusual circumstances. This, 
of course, is most to be desired educa- 
tionally, though to some it seems rather 



risky to encourage home modification in 
the surroundings found in some quar- 
ters. At the New York Milk Commit- 
tee's stations all the modifications are 
made from whole milk, not cream. In 
fact, whole milk and barley water seem 
to be used more and more as the foun- 
dation of all formulae, and it would be 
interesting to compare the results ob- 
tained from the two methods of feeding. 
Unfortunately most of my experience 
has been with the cream mixtures. I did 
help start a milk station in Springfield 
this summer, at which the whole milk 
formulae were used, but my stay was 
too short to thrpw any light on the sub- 
ject. 

There are several motives at work 
back of the present enthusiasm for milk 
stations. The main motive everywhere 
is the reduction of infant mortality, the 
prevention of a lot of unnecessary 
deaths, and, incidentally, the building up 
of stronger bodies for those who would 
in any case survive. One runs across 
people who maintain that the milk work 
keeps alive a lot of miserable babies wlio 
would be better off out of the world, 
and when we see some of the miserable 
specimens we might without further 
knowledge be inclined to agree, to a cer- 
tain extent, with this view. Who is to 
tell, however, whether these same miser- 
able specimens, if left to the conscien- 
tious but ignorant care of their parents, 
will die or live on in the same miseraWe 
condition? And who that has worked 
for any length of time among such bab»es 
has not seen some of them at least, when 
they got the right food, pick up and fill 
out and become as fine babies as one 
would wish to see ? It is very wonderful 
what proper food will do for a baby, and 
where there is no real disease a baby 



MILK STATIONS 



225 



cannot be condemned for being merely 
skin and bones. 

Educationally, the milk work may thus 
be made most effective. It approaches 
people on the side where they are per- 
haps most easily led, the side of their 
love for their babies. Parents realize the 
necessity for care in the feeding and 
tending of their babies as nowhere else, 



and education along this line makes a 
good foundation for education along 
other similar lines. Moreover, through 
this education the babies, our future citi- 
zens, are given a better start in life, the 
foundations of our constitutions, as of 
our characters, being formed to a com- 
paratively large extent in our earliest 
years. 



Practical Points 



With pleasure we welcome zt\ interesting 
and useful invention by a nurse, Mrs. F. E. S. 
Smith, secretary of the Missouri State Board 
• of Examiners, Kansas City, who has invented 
a solitaire board, which she has recently put 
on the market and which will be welcomed in 
hundreds of sick rooms. 

It consists of a flat board with a support 
which opens out from the board, the board it- 
self being cut out at the bottom to fit around 
the body of the patient. The board can best 
be described as plaited with tight plaits run- 
ning up from the bottom, each plait deep 
enough to hold firmly a card or several cards. 
Thus a patient lying flat in bed can have the 
board placed around his or her body, where 
it will rest comfortably and with so little 
weight that it will not disturb any patient who 
is well enough to think of playing cards. On 
account of the support, the board has the 
proper slope and will not hurt the eyes, and 
by placing the lower end of the cards in the 
folds or plaits, the patient can play solitaire 
or any single game just as comfortably as if 
1^ or she were playing at an ordinary table. 

The board is not expensive and those who 
are interested will see an advertisement in this 
issue of the magazine. We wish Mrs. Smith 
every success with her very praiseworthy in- 
vention, and trust that more nurses will see fit 
to devote a little time and energy to the in- 
vention of something which will bring as 
much gladness into as many sick rooms as 
will this invention. 



by wrapping warm bricks in paper and laying 
them in the bottom of the basket. Over these 
lay a thick blanket folded. Hot water bottles 
may be laid on each side with a roll of 
blanket between. A blanket is then unfolded 
so as to line the basket completely and the 
incubator is ready for the baby. The basket 
should never be placed on the floor. The 
temperature of the room and of the incuba- 
tor heating appliances should not be allowed 
to vary much. It is highly important that 
such babies have abundance of good air to 
breathe and ventilation should be carefully 
attended to. 



To make carbolized oil, add to two ounces 
of pure olive oil one-half drachmn of pure 
carbolic acid. 



A clothes basket incubator for very small, 
weak, or premature babies may be improvised 



Most nurses find trouble in getting good 
results in giving continuous saline, and I 
know the following idea will make it an easy 
matter, with no guess work. 

From your saline can connect a good 
length of rubber tubing, to the free end of 
the tubing fit the large end of a hard rubber 
faucet, which can be bought at any supply 
house, to the small end of the faucet attach 
a catheter. 

Before inserting the catheter you can regu- 
late the number of drops per minute by 
means of the faucet. 

Now you can elevate your can as high as 
you wish above the bed. If your rubber tub- 
ing is warm your saline is at the correct 
temperature. 



fiumuQ in 3fnfanttle ^aral^dts 

(Acute Poliomyelitis) 
l£ grand kerr, m.d. 

Vlfiltinsr Physician to the Children*8 Wards of the Methodist Episcopal, the Buahwick, the Will- 
iamsburerh, and the Swedish Hospitals. Consultlnsr Physician to the Indus- 
trial Home for Children and the East New York Hospital. 



ONE of the most unsatisfactory 
things in the practice of medicine 
among children is the care of a victim of 
infantile paralysis. I use the term "in- 
fantile paralysis" simply because it is the 
more commonly used one to distinguish 
the disease, acute poliomyelitis. Until re- 
cently what knowledge we have had of 
the disease has been entirely inadequate 
to its proper care and treatment, and 
even with the ra/pid strides made in our 
knowledge of the disease within the 
past year or two the care and treatment 
still remain somewhat unsatisfactory. 

It is idle now to attempt to deny the 
infectiousness and contagiousity of the 
disease. Because we have yet failed to 
determine conclusivly the exact mode of 
infection is no excuse for inactivity in 
the presence of an isolated case or an 
epidemic. 

Much of our inactivity has been occa- 
sioned by the fact that the disease does 
not commonly affect more than one 
member of a family, but this probably 
has its explanation in individual suscep- 
tibility. There seems to be clear evidence 
that there exists an individual suscepti- 
bility to the disease, and that this sus- 
ceptibility is strongly influenced by age, 
for in the large majority of instances the 
disease attacks those under the age of 
three years. As it is impossible to deter- 
mine just which members of a family are 
susceptible, precautions must apply to 
all. In considering the nursing problems 
as applied to this most defomiing 



scourge of childhood, it may be well to 
do so from the following standpoints: 
In the presence of a known epidemic, the 
acute stage, the care of the later stages. 
In the presence of a known epidemic 
the attitude of the nurse should 
be one of constant watchfulness to 
prevent infection and also to detect at 
once the first signs of the disease. To 
prevent infection the question of re- 
moval from the affected area may arise, 
and in such instances the advice should 
be to hasten such removal. However, 
such a measure is usually impractical and 
will not be considered by the parents. 

Enough of the mode of infection is 
known to cause us to be very zealous in 
the matter of the toilet of the nose and 
mouth. At least every six to eight hours 
the nose and mouth should be cleansed 
with a mild antiseptic solution^ and this 
should not be done in the usual hasty 
fashion, but must be done thoroughly. 
Any one of the many pleasant but mild 
antiseptic solutions may be used, if prop- 
erly diluted. As such solutions must be 
used over a long period, spraying appa- 
ratus should not be used, but in an in- 
fant the cleansing may be done with a 
small glass syringe for the nose and cot- 
ton for the mouth. In older children, 
teaching them to douche the nose is a 
simple matter. The skin should be kept 
in the best possible condition, and this 
involves the use of a warm cleansing bath 
daily, which may be followed by the 



NURSING IN INFANTILE PARALYSIS 



227 



colder plunge in older children if desir- 
able. 

The diet should be restricted to those 
things which maintain health and pro- 
mote bodily vigor. The merely pleasing 
things should be for the time discon- 
tinued. The diet should be such as will 
make the body more resistant to infec- 
tion and disease, therefore the well- 
cooked cereals, vegetables, eggs and milk 
should be given in increased abundance, 
while meats and sweets are somewhac 
restricted in proportion. 

It is absolutely necessary that the 
bowel function be performed daily, and 
if habit has promoted constipation no 
time should be lost in correcting this 
fault. 

In the acute stage of the disease the 
same scrupulous care must be given to 
the nose and mouth, with the additional 
precaution that everything that comes 
into contact with the secretions from 
these parts must be burned or boiled. 
Therefore it is always better to use 
gauze for kerchiefs and to have separate 
eating utensils for the stricken child. 

It is practically impossible with our 
present knowledge of the disease to diag- 
nose it before the appearance of the 
paralysis, but in the presence of a known 
epidemic there are symptoms that may 
be suggestive. The more suggestive ones 
are fever, diarrhea, vomiting and slight 
cough, and I am convinced that we 
should be suspicious of this combination 
of symptoms occurring in a child under 
the age of five years, if they could not be 
positively explained upon some other 
basis. Then if the disease is suspected 
the child should be placed in a hot blan- 
ket pack and kept there sufficiently long 
to induce profuse perspiration. One such 
application is all that is neces«^ary, for 
repetition might exhaust or depif^ss the 



patient. There is one precaution, how- 
ever, that must be remembered ; in some 
of these acute cases there is a transitory 
loss of sensibility of the child's skin, and 
if this is disregarded severe burning may 
result, as the child will not complain of 
the heat. Water should be given freely ; 
in fact, its ingestion should be encour- 
aged. For the first day or two the water 
should be given hot. Hot lemonade or 
orangeade is usually more acceptable to 
the children. The bowel should be im- 
mediately emptied by a hot enema (no 
Fahr.), and in this should be dissolved 
one ounce of sulphate of magnesia and 
two ounces of glycerine to the pint of 
water. A single dose of castor oil should 
immediately follow the use of this enema. 

Mental and physical rest must be rig- 
idly enforced, and this means that the 
child should be placed in a cool, quiet, 
darkened room and allowed no attend- 
ant except the nurse (and in some in- 
stances the mother), and no toys. 

The relaxing of this vigorous sick 
room regime should be most gradual and 
only as the marked improvement of the 
child's condition demands it. I must 
warn against the darkened room also 
being an illy ventilated one, for fre- 
quently such is the case, but with judg- 
ment light may be excluded and yet per- 
fect ventilation be secured. 

The patient should not be allowed to 
lie upon the back, but must be turned 
very frequently upon either side. There 
are two things that we ought to avoid as 
far as the spine is concerned — pressure 
and heat. 

The diet for the first twelve hours 
should be nothing except hot sterile 
water, and for the period in which fever 
is present it should be restricted abso- 
lutely to fluids. Even milk should not be 
given in its usual full strength, but is 



•I 



228 



THE TRAINED NURSE AND HOSPITAL REVIEW 



better if used as follows: Dip off the 
top sixteen ounces from a quart bottle 
of milk in which the cream has risen, and 
dilute it with an equal quantity or more 
of water, and use in place of ordinary 
milk. 

The question will undoubtedly arise as 
to how long the strict isolation of the 
patient should be observed. There is but 
one safe guide, and that is the tempera- 
ture, and as long as there is fever present 
isolation must be strict. 

The care of the later stage is princi- 
pally directed toward the prevention or 
limitation of atrophy of the af- 
fected muscles. It must be recalled 
that the first onset of the paralysis 
is much more widespread than it will be 
later, and that within a few days after 
the occurrence of paralysis there will be 
a very considerable recovery of power in 
most of the muscles. But those that re- 
main paralyzed will show a tendency 
to rapid degeneration and wasting, and 
this must be combated. As soon as the 
acute stage has passed the affected mus- 
cles should be carefully but thoroughly 
massaged for at least fifteen minutes 
three or four times a day. The best lubri- 
cant to use is goose oil, because it is very 
absorbent, has a low melting point and 
leaves no greasy residue. During the 
epidemic of 1909, in which I was able to 
closely study some sixty-five cases, I fre- 
quently used slight constriction of the 
affected linib to limit atrophy. The 
method used was simple ; the nurse once 
daily applied a piece of ordinary rubber 
tubing about the limb as near to the joint 
as possible and gently twisted it until the 
whole limb showed a very slight conges- 
tion and discoloration. This constriction 
was kept up for ten to fifteen minutes 
and then the tubing removed. The tone 
of the musculature seemed to be most 



favorably aflfected by this simple proce- 
dure. The use of the electric current is 
not necessary during the first two or 
three weeks, but after that period its use 
encourages the proper exercise of the 
affected muscles. 

When the electricity is used it has been 
the common practice to abandon the use 
of massage, but such a procedure is rad- 
ically wrong. The massage is most im- 
portant and must be continued, even 
when the electric current is used. I am 
constrained to emphasize the fact that 
electricity and massage (and particularly 
the latter) should be continued over a 
very long period. In fact, they should be 
continued over what may at first seem to 
be an unnecessarily long and hopeless 
period. After a time even the parents of 
an affected child become discouraged 
and are ready to become inactive, but 
this should be combated and the child 
given every possible chance for perma- 
nent relief. If any definite time could be 
set in which this continued effort should 
be carried on with the hope that it would 
result in relief I should place that time 
at not less than three years. I am con- 
vinced that many of the distorted limbs 
of to-day are the result of discourage- 
ment lulling one into inactivity. 

In the very late stages, when it seems 
probable that some sort of a brace will 
have to be worn by the child to prevent 
the strong, healthy muscles of the limb 
from pulling against the weak, paralyzed 
ones and resulting in more or less de- 
formity of the limb, the child's skin 
should be prepared for this mechanical 
restraint. Every day the parts to be sub- 
jected to mechanical pressure should be 
freely bathed with alcohol and salt (one 
ounce to the half pint) or a rather strong 
brine. Such preparation will save coH' 



LESSONS IN CHEMISTRY 



229 



siderable annoyance later on, and will 
inevitably add much to the little one's 
comfort. 

Throughout all stages of the disease 
every advantage must be taken of secur- 



ing perfect elimination of waste prod- 
ucts, a diet somewhat more than neces- 
sary for the child's immediate needs and 
hygienic surroundings of the best ob- 
tainable kind. 



^t&nona in €fitmisittv for fimatsi 

MINNIE GOODNOW. 
Superintendent Bronson Hospital, Kalamazoo, Mich. 



TVT ANY of the elements are familiar 
^ ^ to us. Others need description. 
Hydrogen is a gas without color, 
taste, or odor. It is the lightest of all 
known elements. Hydrogen is rarely 
found uncomibined; it has a great affin- 
ity for oxygen, the two combining read- 
ily to form water. Water being so abun- 
dant, it will be seen that the amount of 
hydrogen in the world is very large. 

Hydrogen is found chiefly in organic 
substances, i. e., plants and animals, and 
in some mineral substances. It burns 
readily, with a very hot flame, combin- 
ing with the oxygen of the air to form 
water vapor. (The oxy-hydrogen blow- 
pipe is a device which produces the 
hottest flame known to science.) 

Oxygen also is a gas without color, 
taste, or odor. It is a very active ele- 
ment, i. e., will combine with almost 
everything. Oxygen forms about one- 
fifth of the air and about one- third of 
the water of the globe ; occurs largely in 
all animal and vegetable matter, and in 
nearly all rocks and minerals. It is, in 
short, the most abundant element, and 
makes up over one-half of the earth's 
surface. Its tendency to combine with 
everything is in a large measure respon- 



sible for the changes which take place so 
constantly in organic compounds, decay, 
rust, combustion, and even the disinte- 
gration of rocks. 

(Water, HgO, is an interesting com- 
pound from the fact that it is a fluid 
formed by the union of two gases; two 
intangible, invisible substances uniting 
to form a tangible, liquid mass.) 

Nitrogen is a colorless, tasteless, and 
odorless gas, which forms four-fifths of 
the air and is in organic and inorganic 
substances in considerable quantity. It 
is very inactive, and under ordinary cir- 
cumstances will hardly combine with 
anything. 

Growing plants and animals need a 
great deal of nitrogen, but are unable to 
obtain it from the air. Their supply 
comes from the nitrogenous compounds 
in the soil and in other plants and ani- 
mals. Blood, muscle, and nerve sub- 
stance contain nitrogen, and the grains 
and some vegetables. Nitrogen does not 
burn, nor does it support combustion. 

(Air is a mechanical mixture, not a 
chemical compound. It contains about 
four parts nitrogen, one part of oxygen, 
and a small amount of watery vapor, 
carbon dioxide, and other substances.) 



230 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Carbon is the chief constituent of all 
organic substances. Three forms in 
which we -best know it are coal, dia- 
mond and graphite (the lead of pencils). 
Charcoal, bone-black, lamp-black, coke, 
peat, petroleum, asphalt, etc. are more 
or less pure carbon. Marble, limestone 
and chalk are compounds of carbon. 
Sugar, starch, vegetable fibers, fats, oils, 
alcohol, ether and innumerable other 
substances are carbon compounds. 

Charcoal, which is almost pure carbon, 
absorbs large quantities of gas into its 
pores. This makes it a valuable disin- 
fectant and deodorant in the sick room. 

Carbon dioxide, also called carbonic 
acid gas (CO^), is one of the most im- 
portant carbon compounds. It is formed 
during combustion, and is thrown off in 
considerable quantity by animals in the 
process of breathing. (See Lesson VI.) 

Sulphur is a yellow, crystalline ele- 
ment more or less familiar to us. It oc- 
curs in the earth uncomfbined, especially 
in volcanic regions. Small quantities are 
found in plants and animals, as in mus- 
tard, yolk of eggy bile, hair, etc. Sulphur 
is used in bleaching and as a germicide. 

Phosphorus is a common element, but 
not an abundant one. It occurs in many 
rocks (in combination), in the soil, in 
seeds and grains, in the bones and brains 
of animals, in urine, blood, etc. It does 
not occur in nature uncombined. Pure 
phosphorus is a violent poison ; it is the 
chief ingredient in matches. 

Calcium, commonly called lime, occurs 
as marble, limestone, chalk, in plants, in 
animals and in water. It is an important 
constituent of bone, teeth, shells, etc. 

Sodium is a silver-white metal, never 



occurring alone. It cannot be kept in 
water or air on account of its great 
affinity for oxygen; it is only preserved 
in the pure state by being placed under 
naphtha or some liquid which contain? 
no oxygen. (If a small piece of sodium 
can be obtained, exhibit it and show its 
action when dropped upon water. It im- 
mediately breaks into a bluish-white 
flame.) 

The commonest and most important 
compound of sodium is the chloride, 
common salt. It forms about 3 per cent, 
of sea water, and some of the salt lakes 
contain nearly 30 per cent. It occurs as 
rock salt in many parts of the world 
(Poland and Spain) ; in our own coun- 
try, as in New York and Michigan, it is 
obtained by evaporating the brine from 
salt wells, slow evaporation producing 
large crystals; rapid, small ones. It is 
found in the blood of animals and in 
their bones. Normal salt solution con- 
tains the same amount of salt as humati 
blood does, and is often used to supply 
a loss in case of hemorrhage or in col- 
lapse. It is a direct heart stimulant, act- 
ing not as a spur, but as material upon 
which to work. 

Sodium chloride is used largely in 
manufacturing other products. Sodium 
sulphate, Glauber's salts, a hydragoguc 
cathartic, is made from salt and sul- 
phuric acid. The reaction is as follows; 

Sod. chlor Sulphoric ac. Sod. sulph. Hydrochloric ac. 

2NaCl plus H2SO4 = Na2S04plus 2HC1 
Sodium carbonate (washing soda or 
sal soda) and sodium bi-carbonate (bak- 
ing soda) are also made directly from 
salt. Sodium hydrate, or caustic soda, is- 
another common soda compound. It is 
a strong alkaji, used in soap-making. 



Snatom^ anb $i)p£(tolos$ 



The Circulation System 



CLARA BARRUS, M.D. 



\I[7E now come to study the lAtal 
^^ processes of the body, those 
processes by which life is carried on, 
growth is accomplished and waste mate- 
rials are removed. These functions are 
those of circulation, respiration, alimen- 
tation and excretion. 

In this chapter we shall study, in part, 
the circulatory system. This is made up 
of the heart, the arteries, the veins, th'i 
capillaries and the lymphatics. By 
means of these structures the nutrithc 
fluid, blood, is made to circulate through 
all the tissues, to nourish them and to 
carry away the materials not needed for 
nourishment. 

Blood is the carrier of oxygen and of 
digested food material to all parts of the 
body. From it tissues appropriate what 
they need and to it give up their refuse 
matter, which is carried in the blood 
stream to those organs which separate 
the waste materials and cast them out of 
the system. The blood also serves to 
warm and moisten all parts of the body. 
The heart is the center of the circula- 
tory system; by means of alternate con- 
traction and relaxation it propels the 
blood into the vessels called the arteries; 
the capillaries are very small, hair-like 
networks of tubes that ramify in all the 
tissues. The blood passes from the 
arteries to the capillaries; while the 
blood is in the capillaries the interchange 
of food and waste materials is made 
through the thin walls of the vessels; 
the veins then conduct the impure bloo<l 
back to the heart, thus completing the 



circulation. The blood is in constant 
motion during life, an out-going current 
escaping from one side of the heart and 
an in-coming one entering at the same 
time on the other side. 

The heart is a hollow muscular organ, 
shaped like a cone, situated in the chest 
behind the breast bone and between the 
lungs; it is enclosed in a membranous 
bag called the pericardium, which also 
covers the roots of the great vessels as 
they arise from its base. The heart lies 
obliquely in the chest, nearer to the front 
than to the back, with the broad part of 
the cone directed upward, backward and 
to the right, and the apex downward, 
forward and to the left. At its base it 
admits of limited motion, but its apex is 
more freely movable. It is the apex beat 
that we can feel and often see in the 
space between the fifth and sixth ribs, 
about three inches to the left of the 
sternum. In size the heart is about as 
large as one's fist; its average length is 
five inches, while its breadth is about 
three and one-half inches in its broadest 
part and its greatest thickness is about 
two and one-half inches. It weighs from 
eight to twelve ounces, varying in size in 
different individuals, and being larger in 
men than in women. Its chambers hold 
from four to six ounces. 

The pericardium which encloses the 
heart is a fibro-serous membrane made 
up of two layers, a strong fibrous one on 
the outside and a serous one on the in- 
side, investing the heart and then being 
reflected upon the inner surface of the 



1 



232 



THE TRAINED NURSE AND HOSPITAL REVIEW 



pericardial sac. The opposing surfaces 
glide smoothly over each other during 
the movements of the heart, because the 
serous membranes are bathed with a 
thin fluid which keeps them well lubri- 
cated. The pericardium is attached to 
the diaphragm below, while above it is 
attached to the external coats of the 
large blood vessels as they branch off 
from the heart. 

The chambers of the heart are four in 
number. The organ is divided into a 
right and left heart by a muscular par- 
tition running lengthwise, while a trans- 
verse constriction subdivides each side 
into an upper and a lower chamber. The 
upper chambers are called auricles from 
a fancied resemblance to a dog's ears ; the 
lower ones are called ventricles. There 
are openings between the upper and 
lower chambers on each side, but no 
means of communication between the 
right and left sides. The heart is, there- 
fore, like a double house built for two 
families, each house having its front and 
rear doors, but with no interior com- 
munications between them. Both halves 
of the heart act together in point of time, 
but each half has its separate duty to do, 
the right half always to pump along 
venous blood and the left half always to 
propel arterial blood. The right auricle 
is at the base of the heart. It is lined, as 
is all the heart, with a smooth, glistening, 
serous lining called the endocardium. 
Opening into the right auricle are two 
large blood vessels, the superior and in- 
ferior venae cavae, which bring the 
blood from all parts of the body; the 
superior vena cava returns the blood 
from the upper part of the body, while 



the inferior vena cava returns it from 
the lower part. Several small veins of 
the heart itself also open into the right 
auricle. 

The right ventricle forms the large 
part of the front of the heart; it is tri- 
angular in shape. Its walls are thinner 
than those of the left ventricle. 

The opening between the right auricle 
and the right ventricle is guarded by a 
three-cusped valve, the tricuspid, so ar- 
ranged as to prevent the blood from 
passing except in one direction, down- 
ward. The bases of these cusps are 
firmly held to columns of muscular tissue 
on the walls of the ventricle by slender 
tendinous fibres, the chordae tendinae; 
these are the "heart strings" we hear so 
much about. 

Semi-lunar valves formed of three 
semi-circular folds guard the opening 
into the pulmonary artery. 

The left auricle has thicker walls than 
the right; it receives on either side two 
pulmonary veins. 

The left ventricle occupies the chief 
part of the posterior portion of the 
heart ; it is longer and more conical than 
the right, projecting beyond it in front 
and forming the apex or point of the 
heart. Its walls are about three times as 
thick as those of the right ventricle. 

The opening between the left auricle 
and the left ventricle is guarded by a 
two-cusped valve called the mitral valve, 
similar in structure to the tricuspid, but 
much stronger because of the greater 
strain put upon it; this valve is held 
down, as is the tricuspid, by tendinous 
cords attached to the muscle columns of 
the ventricular walls. 



(To be continued.) 



Cf)e fimsit*& But^ ilesartitns plaster Bresidtngfii 



CHRISTINA GRACE RANKIN. 



TTHE nurse's duty regarding plaster 
-*• dressings usually begins with the 
making of the bandages. For this the 
best grades of plaster should be secured 
— ^never the common grade used on walls. 
It is better, unless a great number of 
bandages are being used, to get the plas- 
ter in ten pound tins, which should be 
kept sealed with adhesive plaster or with 
some of the plaster cream. The crino- 
line used varies in quality. The kind 
used by milliners for lining hats does 
very well, or it can be purchased direct 
from the suiTgical suipply houses where 
other bandages are procured. The 
average length of a bandage is aJbout five 
yards and the width two and a half 
inches. A plaster bandage narrower 
than two inches is rarely called for. 

The powdered plaster is spread evenly 
and smoothly on the bandage so as to get 
into the meshes and very loosely rolled. 
Each bandage is then -wrapped in paper 
and placed in a covered tin bucket or 
canister, the lid being sealed by adhesive 
plaster. 

When a plaster dressing or "cast" is 
to be applied, it is the nurse's duty to 
get the patient ready for it and to have 
the appliances needed by the surgeon at 
hand. Some padding or protection of 
the part is always required. Common 
cotton batting is preferable to absorbent 
cotton for protecting the part and espe- 
cially for propecting points such as the 
ankle, heel, etc. The absorbent cotton 
absorbs moisture from the wet bandages 
and also perspiration and soon loses its 
elasticity. If a plaster jacket is to be ap- 
plied, a neatly-fitting cotton undershirt 



is used. On the foot and leg stockings 
may be used or the limb may be encased 
in cotton, which is held in place by a cot- 
ton or gauze bandage. If the shoulder 
and breasts are to be included in the 
plaster cast the axilla and breasts should 
be first washed with soap and water, 
rubbed with alcohol, dried thoroughly, 
and dusted with talcum powder before 
applying the protective dressing. Tin 
strips are sometimes used to reinforce 
the dressing, and if holes are made in 
them with an awl or nail alternately in- 
ward and outward, the rough edges will 
be easily gripped by the plaster and thus 
prevented from slipping. Before the ap- 
plication of the plaster dressing is to be 
made, the floor and surroundings should 
be protected by a sheet or by newspapers. 

If good planter is used salt will not be 
needed to aid or hasten the setting. A 
basin is required — one that is deep 
enough to submerge the bandages, one 
by one, with the end up. Lukewarm 
water is most frequently used. Hot 
water is said to hasten the setting of the 
plaster and cold water to retard it. 

The bandage should be at once covered 
with water, and when the bubbling has 
ceased it is lifted and gently squeezed 
with a hand over each end. Loose 
threads are freed from it and the end 
found for the surgeon. It is handed to 
the surgeon with a few inches of the end 
held out and the body of the roller up- 
ward. Some dry plaster should be at 
hand to rub on, and as soon as one band- 
age is taken out of the water, another is 
put in. 

When the plaster is to be applied over 



234 



THE TRAINED NURSE AND HOSPITAL REVIEW 



the groin of children, or in adults where 
there is danger of soiling with urine, a 
piece of rubber tissue is often put in over 
the edge and covered by the last turns 
of the bandage. 

It is then the nurse's duty to see that 
the patient maintains the position de- 
sired for the cast, until the plaster is dry. 
When the dressing is applied to a leg or 
arm the fingers and toes are left uncov- 
ered and should be closely watched so as 
to be sure that the dressing is not inter- 
fering with the circulation. Sometimes 
when an edge is irritating the skin some 
relief can be given by slipping in at the 
edge a little extra cotton. In any case, 
signs of irritation should be watched for 



and reported to the surgeon. A portable 
basin should be provided for the prelim- 
inary cleansing of the hands, as very 
much plaster, or hardened bits of plaster, 
are liable to interfere with the plumbing. 
A little washing soda is a help in getting 
the plaster off the hands. 

A variety of knives and similar appli- 
ances have been invented for removing 
plaster dressings, but any strong knife 
with a sharp point may be used. Some- 
times wetting the bandage with a sponge 
along the line where it is to be cut is 
done to soften the plaster and facilitate 
the cutting. The floor and bed need to 
be protected as when the application was 
made. 



Changes in the Navy Nurse Corps. 

APPOINTMENTS. 

Maud L. McKennie, graduate of the Brook- 
lyn Hospital Training School ; Telia B. Erwin, 
Lakeside Hospital, Cleveland, Ohio; Mary R. 
Gillette, University Hospital, Philadelphia, Pa. ; 
Lily E. White, St. Vincent's Hospital, Norfolk, 
Va.; Ruth R. Kuhn, University of Maryland 
Hospital, Baltimore, Md.; Mary R. Ridgway, 
Providence Hospital, Washington, D. C. ; 
Claribel Pike, graduate of Danvers Hospital, 
Hathorne, Mass., Post-Graduate Bellevuc 
and Allied Hospitals; Martha A. Brooke, Jef- 
ferson College Hospital, Philadelphia, Pa., 
surgical nurse Touro Infirmary, New Orleans, 
La.; Susie L FitzGerald, St. John's Hospital, 
Lowell, Mass., late supervising and operating 
room nurse Boston Emergency Hospital. Miss 
FitzGerald was appointed to the nurse corps 
last October, but through an oversight her ap- 
pointment was not published. 

TRANSFERS. 

From the Naval Hospital, Norfolk, Va., 
Thomasina B. Small, to the Naval Hospital, 
Mare Island, Cal., and Mary C. Nelson, to 
the Naval Hospital; Brooklyn, N. Y. ; from the 



Naval Medical School Hospital, Washington, 
D. C, to the Naval Hospital, Norfolk, Va.. 
Sara M. Cox and Sara B. Myer. 

Esther V. Hasson^ 
Superintendent Nurse Corps, U. S. N. 

+ 
Changes In the Army Nurse Corps. 

APPOINTMENTS. 

Clara E. EUwanger, graduate of the Bur- 
lington Hospital, Burlington, la. ; employed for 
three years in the Pcnnoyer Sanitarium, 
Kenosha, Wis., and head nurse at St. Ber- 
nard's Hotel Dieu Hospital, Chicago. 

DISCHARGES. 

Josephine Anslyn, August 31, 1910; Marga- 
ret T. Wahls, August 31, iQio. 

TRANSFERS. 

Gertrude H. Lustig, from San Francisco, to 
Fort Bayard, New Mexico; Ruby E, Nichols 
and Mary E. Wimbish, from San Francisco, 
to Philippines Division, September 7, 1910; 
Gertrude B. Gilstrap and Louise H. Gutberlct, 
from Division Hospital, to Fort William Mc- 
Kinley, Rizal, P. L Jane A. Delano, 

Superintendent Army Nurse Corps. 



I^uman j^ature an)) a fiuxst 



H. RIVERS. 



{Continued from August.) 



A MAID ushered nie into the parlor 
* ^ of the home of my second 
private patient, where I was at once 
joined by a tall, slender lady in black. 
She told me her mother, quite an old 
lady, had been ill three weeks, and 
though she herself was an invalid, she 
had cared for her, as they were 
both greatly opposed to trained nurses. 
They never had employed one 'before 
and now, I must understand, it was only 
because her strength had given out that 
one had been called in. I would find lit- 
tle to do and my stay would be short, as 
the physician had said that morning her 
mother could not live twenty-four hours. 
Her whole 'bearing was so frigid it was a 
relief to hear my stay would be brief. 

Besides, through general debility, 
rheumatism and cystitis, my patient^s vi- 
tality was still further drained by a bad 
bedsore near the end of the spine and by 
a long gash across the top of her head, 
received while trying to get out of bed to 
wait on herself. This had been drawn 
together with eight stitches. So the 
"little" I had to do in twenty-four hours 
was to dress the bedsore three times, 
look after some stitch-hole abcesses, use 
the battery, rub her twice with liniment, 
give an enema, irrigate the bladder twice 
and catheterize p. r. n. in addition to 
the regular work. I was luckily too busy 
to be very much depressed by the atmos- 
phere surrounding me. 

Then, too, I missed the council and 
advice upon which I had learned to lean, 



as all pupil nurses do, at the hospital. 
Was I right in thinking it unnecessary to 
summon the doctor, or would the patient 
die because I was too stupid to note 
alarming symptoms? Three o'clock one 
morning as I stumbled down the steep 
back stairs on an errand to the kitchen, 
worrying over my decision, I found my- 
self unconsciously repeating part of the 
Collect for the first Sunday after the 
Epiphany: "Grant that [I] may both per- 
ceive and know What things [I] ought to 
do and also may have grace and power 
faithfully to fulfill the same." Since 
then I have always thought of that par- 
ticular prayer as one especially suited to 
the private-duty nurse. I know it helped 
me. 

When my third afternoon with no 
time off faced me I asked the daughter 
at the lunch table if she thought she 
could spare me for two hours, as it 
would be perfectly safe for me to leave 
her mother for that length of time. 

"No," she "couldn't think of it." How- 
ever, a still, small voice, I suspect, led 
her to change her mind, for she suddenly 
appeared before me with "if I let you go 
for two hours will you promise me you 
will surely return?" Assuring her I 
would not dream of doing otherwise I 
prepared for my outing, secretly pleased 
at the tacit admission she had misjudged 
the members of my profession. Evident- 
ly she remembered the reception she had 
given me and felt that after demonstrat- 
ing our worth it would only be what she 



236 



THE TRAINED NURSE AND HOSPITAL REVIEW 



merited if I now left her in the lurch. 

When I returned to the sick room I 

knew I would no longer be kept in cold 

storage, but was actually regarded as an 

acquisition. Six weeks later, feeling 

worn out, as the case, while pleasant, 

was a hard one, I turned the patient over 

to another nurse, who, proving equally 

satisfactory, the family frankly admitted 

they had been won over and gladly paid 

tribute to the virtues of the trained 

nurse. 

****** 

A knock on the door roused me up and 
the voice of the lady of the house — a 
member of the aristocracy and of a 
select social set — inquired if I would like 
to take her young daughter to the mati- 
nee that afternoon. She had been unable 
to find any one to chaperon her and 
thought perhaps I had had sleep enough 
to carry me through the night — I was on 
night duty caring for a member of the 
family — and would enjoy going. One 
does not say no to a chance of hearing 
the Metropolitan Company in Grand 
Opera, and I was wide awake in an in- 
stant. Replying to her- inquiry as to 
whether I had all I needed to wear, I 
told her yes, with the exception of gloves 
— ^as it was Winter I had only mittens 
with me, but in going we would have to 
pass my home and I could stop for a 
pair. She thought that would delay us 
and oflFered me a pair of hers — "that is, 
if you can get them on. What size do 
you wear?" Thankful that a substantial 
door hid the laughter in my eyes, I meek- 
ly replied, "Five and three-quarters." 
"Oh!" (hastily) "you will have no trou- 
ble then. I will send you a pair at once." 
When they were handed in and the door 
safely shut, the "person" who worked 
with her hands for her bread and butter 



and such promptly looked for the size of 
the lady of high degree, and when she 
saw the figures 6)4 she smiled — in appre- 
ciation, not in malice. 

****** 

While the Spanish-American War was 
a little pocket handkerchief affair com- 
pared with our civil conflict, it was long 
enough to develop many a hero. 

The night had been hard and long in a 
surgical ward in one of the army hos- 
pitals, and through it all I had comforted 
myself that at least one of my patients, 
Lieutenant X., had been free from suf- 
fering and able to sleep. In fact, he had 
not changed his position all night. In 
the early dawn, passing by the foot of his 
bed, I was shocked to find he had, by 
moving his arm, revealed a face as grey 
as the dawn itself. I exclaimed, "You 
have laid here all night in pain. Why 
didn't you let me know?" He wearily 
replied there was nothing to be done, and 
besides the others had needed me. "Well, 
they don't need me now and I am going 
to see what rubbing will do for your leg." 
While the wounds had healed, they had 
been so extensive as to make the Lieu- 
tenant still a cripple, unable to leave his 
bed. I knelt down with my back to his 
face, so he should not feel he was being 
watched, and began to rub. In ten min- 
utes the muscles started to relax and in 
half an hour he was sleeping soundly and 
did not waken until long after the day 
nurses had come on duty. 

After that I kept a closer watch on 
him, but while he did not try to hide his 
sufferings, he always insisted upon wait- 
ing until all the others were cared for, 
which often made it after midnight be- 
fore I was at liberty. 

One of the other patients, a private, 
shot through the right lung, had been at 



HUMAN NATURE AND A NURSE 



23: 



death's door for some time, and his re- 
covery seemed doubtful. He slept well 
through most of the night, but wakened 
in a cold perspiration and with all the 
symptoms of extreme prostration. One 
of my duties was to keep an eye on him 
and give him a drink of whiskey at once 
when he stirred. This proved very ben- 
eficial and he slept longer each succeed- 
ing night. One morning he slept un- 
usually late ami the others were all 
awake having their toilets made when he 
roused up. As I carried him his whiskey 
Lieutenant X. laughingly called to me to 
bring liim some, too. In the same spirit, 
I asked for his written order from the 
ward surgeon, which, of course, he could 
not produce. He teased and coaxed and 
finally ordered and commanded me to 
bring him some whiskey. This I could 
not do without the surgeon's order, 
which I did not have. 

I am quite sure he was not a drinking 
man and had begun in a spirit of fun, 
which eventually changed to deadly 
earnest. He grew so offended and angry 
I went off duty very mucfh depressed. I 
dreaded going back to the ward that 
night. His patience, unselfishness and 



courage had won my hearty admiration, 
and while as far as I was concerned the 
unfortunate incident would willingly be 
dropped, I had no means of knowing the 
extent of his capacity for sulking. 

That evening I departed from my 
usual custom of going to each bedside 
and speaking to the occupant; I only 
went to those who would require most of 
my care, and then repaired to the diet 
kitchen to inspect my supplies. Here the 
corps man found me and said a certain 
boy with a broken leg wanted me. I for- 
got at the moment his bed was across the 
aisle from the Lieutenant's. As I ap- 
proached him he shook his head and 
pointing to the Lieutenant, said: "It's 
him who wants you." Sick at heart and 
fearing I knew not what, I turned 
toward the Lieutenant. He had pulled 
himself up into a sitting position with his 
hands locked around one knee. As I 
faced him his voice rang out in no un- 
certain tones : "Miss Rivers, I beg your 
pardon for the way I treated you this 
morning. I promise never to do so 
again. Will you forgive me?" So, after 
all, he was doubly a hero, for he had 
both moral and physical courage. 



The Superintendent of Nurses. 



Midsummer's blazing all-enwrapping heat 
Into the darkened wards forces the noon, 
Sultry and burning, till the senses swoon. 
Sad men and women, as the fierce rays beat, 
Lamenting sore their pain, do rest entreat, 
Urgently praying for that precious boon. 
Coolness, and surcease from their torments 

soon — 
Yea, after anguish, pitying death seems sweet. 
Clad all in white, a woman pauses near. 



A quiet woman, strong to meet their pain. 
Yet bearing in her soul its iron trace. 
Eyes eager watching, heavy with dark fear, 
Rest on her face, and straightway courage 

gain, 
Solaced and strengthened by her spirit's grace. 

J. D. 
The above is an acrostic which forms the 
name of a prominent superintendent and which 
appeared in the Providence Journal of July 30. 



3Satp **aa" 



MYRA ISOBEL STEVENS 
Childrens' Hospital, Los Anseles, Cal. 



YOU would hardly recognize him now 
as the little half-wild, unkempt 
creature who came to us almost three 
years ago. Neglected he certainly was ; 
covered with sores, scraggy hair, he re- 
minded one more of an animal than a 
human child. 

His Mexican mother had never real- 
ized the care a child should have and 
poor little Charlie had Potts disease, 
and we soon put on a Bradford frame, 
then began the training of the little wild 
thing. He was not called Charlie after 
the first few days, but Baby Da. This 
is how the name originated. An abscess 
was dressed daily, the proceeding was 
quite painful, but after a few days of 
crying and screaming during the dress- 
ing, he stood it heroically, made but a 
groan or two, and just as we were nearly 
finished, would say in a pained little 
voice, "Da?" meaning, done? He could 
not speak plainly, he was but little over 
two years. So the nurses called him 
Da, and Baby Da he is called to this day. 

After a week or two the change in his 
appearance was decided, the sores, with 
care, were healing, hair was cut and kept 
tidy, and Baby Da was beginning to 
take notice of things going on in the 
ward. He was not a pretty child, but 
had bright black eyes full of expres- 
sion. Such an affectionate little soul, 
and such a mischief, and, if aroused, 
such a temper. One day a hypodermic 
was ordered to be given ; he was taken 
quite by surprise, it was given so quick- 
ly he had no time to protest. But watch 
his little face as he glares at the nurse. 



see the inward wrath and how his eyes 
seem to get blacker with rage, because, 
not understanding, he thinks he has been 
purposely hurt ; and now the outburst of 
his pent-up feelings. Two little hands 
fly out from under the covers and slap 
each other, "Bad boy Miss, hate you, 
kill you, glad break oo leg," and the pas- 
sion is spent. To him every one is boy, 
doctors, patients and nurses, and there 
being several fracture cases in the ward 
at the time, what worse wish than *'I 
would be glad if oo break oo leg." 

He is generous to a degree to those 
he loves. To a little girl in the room he 
will give any of his toys; it is Mandie 
this and Mandie that, but let any one 
else dare to touch those toys and Kce 
him. He is now the life and mischief 
of the ward, and how we all love him. 
Always at night, when the light is put 
out, a little voice from Baby Da*s bed 
pipes "Oo'd nigbt," and go into the 
ward any time during the night, no mat- 
ter how many times, and click you turn 
off the light, he stirs in his sleep, and 
"Oo'd night" in a sleepy almost uncon- 
scious voice is what you hear. What a 
picture he made last night as I came on 
duty, fast asleep with a brown Teddy 
bear cuddled up in his arms! I looked 
long and sadly at the little one; he is 
to go home soon. Home! The father 
is an American man, who has left the 
mother, a degraded Mexican woman ; she 
makes claim on the child. Poor little 
soul, you, with your intense nature, 
whether for good or bad, to think you 
have to go with her, a woman of that 



HYSTERIA DURING PREGNANCY 



239 



type. Better far, dear, that you had 
not got well. How we shall miss you 
and think of you. What kind of a man 



will you turn out to be? Poor Baby 
Da, "Oo'd night." God bless and 
guard you, dear. 



I^^dterta Bating pregnane? 



NELLIE BREWER GOODWIN. 



A CASE of much interest came un- 
-^^ der my care a short time ago 
while in charge of a small sanitarium. 
A patient was admitted for treatment for 
intestinal disturbance and was ordered 
complete rest in bed, and was put on a 
strictly peptonized milk diet with treat- 
ment consisting of two high irrigations 
daily. I learned during the following 
week, in caring for the patient, that dur- 
ing pregnancy some months previous she 
had at times been very nervous, but at 
the time she came under my care she ap- 
peared bright and in good spirits, except 
when in pain, which at times became very 
severe. Her child at this time was eleven 
months old. I took the greater part of 
the care of her, giving her the irrigations, 
in hopes of finding out just what might 
cause the severe attacks of pain. Shfe 
weighed one hundred and eleven pounds, 
having gone from one hundred and 
thirty pounds during the last six months. 
One evening ten days later I found 
the patient in great agony lying on her 
right side, with her knees drawn up, 
with a terrified countenance and with 
forehead bathed with perspiration. I 
found her pulse to be one hundred and 
thirty beats a minute and respiration 
rapid. She explained that she felt as 
though there were a lot of knives cut- 



ting her rectum, and said that on using 
the commode a short time previous she 
had passed something which made a 
clinky noise in the agate receptacle. On 
examining the contents, found to my 
horror and surprise a bunch of bent 
pins partly covered with fecal matter. 
I notified her physician at once, 
and he ordered an irrigation of 
the lower bowel, which I gave, and 
which caused most intense pain. In 
the meantime the physician arrived, and 
she was put on the operating table and 
by the use of the rectal speculum, a tena- 
culum and long dressing forceps, he dis- 
lodged and removed a ball of hardened 
fecal matter the size of a large English 
walnut. The patient was then given an- 
other irrigation an passed small particles 
of fecal matter, with several more bent 
pins. The ball of fecal matter, ta 
our surprise, held together over three 
hundred bent pins. 

One week later the patient was dis- 
charged in fine condition, having been 
on full diet four days previous to the 
time of discharge. I learned from the 
patient that during pregnancy while 
sewing she had been in the habit of put- 
ting pins in her mouth, and in her ex- 
treme nervousness would bite, bend and 
swallow them. 



%^ Mitt iittthen 



The Need of Careful Selection and Preservation of Food-Products to 

be Used for the Sick 

MARY H. TUFTS. 



OUR large cities are now reaping the 
many benefits of the work of the 
various Health Commissions, Societies 
for the Improvement of the Condition 
of the Poor, etc. The District Nurses' 
Associations also do an invaluable work 
in teaching hygiene and dietetics, and in 
caring for the poor. 

In the cities among the poorer classes 
the only ones who do not benefit by these 
instructions are those who will not see 
or hear, or those of deficient intellect, 
who cannot grasp the meaning or make 
practical application of the instruction 
they receive. 

The private nurse in her work occu- 
pies a somewhat less independent posi- 
tion in the household of which she is a 
temporary member than that occupied 
by the worker for a public health com- 
mission or charitable nurse association. 

Perhaps this is the reason why the 
private nurse sometimes hesitates about 
openly criticising the unhygienic, unsan- 
itary conditions to be found sometimes 
in even the homes of the well-to-do. 

It is possible, too, that she feels after 
she takes up nursing in families that 
she is only responsible for the prepara- 
tion of foods for her patients, and not 
responsible for the selection and preser- 
vation of said foods. 

No greater mistake could be possibly 
made. The preparation of food for the 



sick is an important part of the nurse's 
work, but, after all, is only a fractional 
part of her responsibility. 

It is a well-known fact that persons 
who are ill or constitutionally weakened 
are extremely liable to reinfection, or 
toxemias, induced by the consumption 
of microbe-laden foods, and by other 
unsanitary conditions. 

The cleanliness, neatness and laws of 
order governing the New England 
housewives are proverbial; and I have 
been surprised, to say the least, by some 
of the actual conditions which I have 
found in my house-to-house nursing 
here in New England. 

It is, of course, a nurse's duty to be 
as diplomatic and tactful as she can in 
dealing with matters regarding which 
{he family in which she works may be 
sensitive or easily offended. But if 
necessary for the protection and welfare 
of her patients she should "speak out" 
in regard to any household conditions 
that are a menace to health and that may 
be remedied by so doing. 

Be it said for the average doctor that 
he is both kind and willing to uphold 
the hands of his nurses in any good 
work, and he may be relied upon to aid 
the nurse in doing away with many ob- 
jectionable conditions menacing the pa- 
tient's welUbeing. 

In regard to selection and preserva- 



THE DIET KITCHEN 



241 



tion of foods, I have found that many 
otherwise intelligent people scout the 
idea that germs are our disease pro- 
ducers; some are interested in this fact, 
however, and the nurse's efforts toward 
securing a perfectly healthful dietary 
for her patient will not be looked upon 
as a "cranky" show of fussiness or au- 
thority, but will be appreciated as in- 
cited by her whole-souled interest in her 
patient. 

I will cite a few of many injurious 
conditions existing in the homes of and 
concerning the health of my patients. 

Milk is prescribed more frequently, I 
believe, than any other food for the sick 
who are on liquid diet. And it is one of 
the foods that is most likely to be laden 
with all sorts of pathogenic bacteria, 
from the fact of its uncleanly and oft- 
times careless handling. 

Judging from my experiences, I am 
compelled to believe that in the average 
instance we are not as sure of being able 
to get as pure milk in the country as we 
do in the city. At first this statement 
will probably sound perfectly absurd, but 
is explained in this way : 

Few country towns have a milk in- 
spector, and those who sell milk are reg- 
ulated largely by their consciences (if 
they have any) and by their ability to 
supply their customers with a milk suf- 
ficiently rich to suit them, or which does 
not fall short in measure, or reach the 
customer in sour condition. 

Comparatively few milk consumers in 
the country know whether the milk is 
produced by healthy cows or not, and 
rarely interest themselves as to the meth- 
ods of handling and caring for the prod- 
uct. 

Many times the members of the 
Boards of Health in country towns fail 
utterly to enforce restrictions as to the 



sale of milk coming from premises where 
infectious and contagious diseases exist. 

Some years ago I was nursing a case 
in a small country village; the family 
procured their milk from a farmer who 
lived a short distance outside the town. 
The farmer who brought the milk to us 
looked clean and tidy in his dress, and 
the milk was always free from objection- 
able odors, and delivered in clean-look- 
ing cans, each customer having his own 
can, marked, so as to prevent exchange 
of oan in delivery. Mrs. M , my pa- 
tient's mother, assured me when I asked 
about the milk supply that it was ex- 
ceptionally clean and good, and said that 
she had been so glad that she could pro- 
cure milk from these people, because 
they were so neat. 

One morning our milkman reported 
that he would be obliged to cut down on 
the amount of milk he brought us, as 
one of his best cows was sick. I was in 
the kitchen when he came, and inquired 
what he thought was the matter with 
the cow. He answered, "I don't know ; 
she hurt herself in the pasture, I guess. 
Two weeks ago she began to go a little 
lame, as if she had wrenched her shoul- 
der ; and now she is off her feed, seems 
feverish, and is so lame that I have to 
keep her in the barn." 

I asked him if he had been milking 
that cow since she had been lame and 
ailing; and he said that he had milked 
her until she lost her appetite, as he had 
not noticed that she was feverish until 
then, or seemed sick from the lameness. 
And I found that our milk supply was 
a mixture of this cow's milk and that 
of three others. 

I was naturally indignant, and refused 
to use for my patient any more milk 
that came from that place, much to the 



242 



THE TRAINED NURSE AND HOSPITAL REVIEW 



indignation of the milkman and my pa- 
tient's family. 

In a few days after this the farmer 
called a veterinarian to treat the cow, 
and was told that the animal was badly 
affected with tuberculosis. The veteri- 
narian notified the State inspectors of 
cattle and the animal was killed. Many 
of the large bones were badly diseased 
and the udder beginning to show tuber- 
cular deposits. 

In another case where I was nursing, 
and the family bought milk from a man 
outside the town, it was found, w'hen t 
had used the milk ten days for my pa- 
tient, that two members of the milkman's 
family were ill with typhoid fever, and 
were being cared for by membefs of the 
family. 

The alvine discharges from these pa- 
tients were being disinfected (?) by a 
hasty mixing with dry chloride of lime 
powder, and emptied into an earth clos- 
et which was exactly nine and one-half 
feet from the well that furnished the 
water supply for all household uses. 
Two members of this household who 
were caring for the sick ones, were also 
caring for the milk cans and pails, cloth 
strainers, etc., and, after waiting upon 
the patients, disinfected (?) their hands 
by washing in soap and water. 

Water in which the patients were 
bathed was emptied into the iron sink 
in the kitchen, where the dishpan and 
general washdish were used. After the 
Board of Health had investigated the 
affair, one of the Board told me that 
while he was at the house where the 
typhoid cases were, he personally saw 
a woman empty a bowl of water in 
which she had bathed one of the pa- 



tients into the sink, and a little later saw 
her wash milk cans without disinfecting 
her hands; and when done using the 
dishpan she had wiped the pan inside 
and out with the same cloth, used to 
wash milk pails and cans. Now, the 
water used for general baths for a ty 
phoid patient undoubtedly contains num- 
bers of typhoid germs; and the proba- 
bility that these germs might get on the 
bottom of the dishpan that was set into 
the sink was very great. 

Later on, when two more people in 
that town developed typhoid, and were 
found to have used milk from the house 
where the original cases were, it was not 
difficult to imagine where the infection 
of the last cases came from. 

The doctor in attendance upon the 
first named cases told the neigfhbors of 
the sick people that they had "bilious 
fever." And, the first I knew of the 
trouble, a little girl from that house 
came where I was nursing and said that 
the doctor said her brothers were "hav- 
ing a mighty light run; and will get 
well all right, even if it is typhoid." 

My patient's family and I held a hur- 
rieo consultation after the child left the 
house, and one of them went imme- 
riately to town and reported the case to 
the Board of Health, and, to our sur- 
prise, found that the doctor attending 
the typhoid cases had not reported them. 

It is needless to say that the Board of 
Health "got busy" and stopped the sale 
of milk from that house, condemned 
the well whence they drew water, and 
required a proper supervision of disin- 
fection, etc., by the doctor in charge of 
the cases. 



(To Be Continued.) 



€tittottaU|> g^peaktng 



Florence Nightlnfi:ale 

Florence Nightingale was perhaps 
the best known and the best beloved 
woman of her time. For more than half 
a century the civilized world has re- 
joiced in her life — a rejoicing now turned 
to mourning at her death. 

As a great reformer of unsanitary con- 
ditions in the English army and hospitals, 
she pioneered a movement which spread 
to all countries, and to her must be 
credited the modern system of military 
hospitals. There is no need to recount 
in detail the story of the Crimea, where 
she won a measure of fame accorded to 
few women — that has been immortalized 
in song and story. But we can dwell for 
a moment with profit upon that splendid 
example of her courage and self-sacri- 
fice, when the British soldiers were dying 
from neglect, when medical attendance 
and supplies were being held up by red 
tape. In this time of dire distress, this 
brave woman took matters in hand, she 
went to the ships and to the storehouses, 
and with Turkish soldiers she brushed 
aside, and fought aside, British guards, 
battered down doors, and brought forth 
the needed stores and comforts. Then 
she prepared the beds, and at the muz- 
zles of Turkish muskets, compelled Br'*- 
ish surgeons to stay by and care for their 
suffering countrymen. 

She worked not only in courage and 
self-sacrifice, but also with rare skill and 
intelligence and with insight into the 
practical needs of the army. The results 
of her investigations were largely the 
cause of India's health reform and di- 



rectly the cause of the English army's 
health reform. 

It is perhaps not generally known tliat 
until very recent years, when failing 
health prevented, she had been one of 
the active advisers of the British War 
Office in all matters pertaining to mili- 
tary hospitals. During our own war be- 
tween the States, and in the Franco- 
Prussian War, her advice was eagerly 
sought and freely given. 

It is also not too well known that with 
a fund of $250,000 popularly subscribed 
in grateful recognition of her services, 
she founded a training school for nurses, 
and that the Red Cross movement, as 
we know it to-day, is largely due to her. 

It is pleasant to recall in the hour of 
her death that the honors so nobly won 
were paid to her while living, and that 
she was spared so many years to wear 
and enjoy them. So long as self-sacri- 
fice and devotion to humanity are rev- 
erenced the memory of Florence Night- 
ingale will be cherished and will furnish 
an inspiration for all those who minister 
to the sick and afflicted. 

+ 
Intellectual Laziness 

In one of his matchless essays Osier 
says that "The killing vice of the young 
jdoctor is intellectual laziness. He may 
have worked hard at college, but the 
years of probation have been his ruin. 
Without special subjects on which to 
work, he gets the newspaper or novel 
habit and fritters away his energy on 
useless literature. There is no greater 
test of a man's strength |han to make 



244 



THE TRAINED NURSE AND HOSPITAL REVIEW 



him 'mark time* in the 'stand and wait 
years.' Habits of systematic reading are 
rare, and in five or ten years from his 
license, as practice begins to grow, we 
niay find the young doctor knowing less 
than he did when he started, and without 
any fixed educational purpose in life." 

What is true of the young graduate in 
medicine is true of the young nurse. The 
nurses are comparatively few, outside of 
those actually engaged in teaching, who 
seem to have formed systematic habits of 
study. The years pass without any defi- 
nite plan for acquiring new knowledge. 
Of the many new and wonderfully inter- 
esting developments along medical and 
surgical lines many nurses with good in- 
tellectual abilities are blissfully ignorant. 
They are not interested, either, or, at 
least, not well informed, regarding sig- 
nificant current events. The facts are 
after graduation they slipped into a rut 
which has deepened with the passing 
years. Their horizon is bounded by the 
four walls of the patient's room; their 
ideals mig^t be summed up for the most 
part in, as one nurse aptly termed it, 
^'Keeping up the nurse's prices and get- 
ting a good long holiday every Summer 
if possible." This is by no means a 
sweeping criticism of all nurses. It is a 
plain statement of facts regarding a 
great many. 

They are too little interested in nurs- 
ing, too well satisfied with their own at- 
tainments, to feel that they could learn 
anything from contemporary nursing 
literature. Good, practical workers many' 
of these are. Years of experience have 
taught them much, but that they owe 
anything to the nurses who come after, 
that they have any responsibility for let- 
ting others have the benefit of their ex- 
perience — well, the idea never seems to 
occur to them. 



Now and again we hear of the nurses 
connected with some special registry ar- 
ranging to take up some special study 
each season, buying books and studying 
together, according to some certain plan, 
but the custom is far from being gen- 
eral. A few nurses in every centre or 
home could do wonders in stimulating 
their comrades to set their brain to work 
along some certain line. Many graduates 
of general hospitals have had little ex- 
perience and practically no theoretical 
work along the line of nervous or mental 
diseases. It would be well worth while 
this coming Fall and Winter to select 
one of these special lines and delve into 
it with a determination to understand 
more of the widely varied forms of those 
diseases and their management. 

Others are weak along the line of chil- 
dren's diseases; others "confess and be- 
wail" their lack of definite knowledge 
along the lines of dietetics, or physical 
therapeutics. Why not decide to get out 
of the rut, to be no longer guilty of the 
"killing vice" of intellectual laziness, and 
this very month make out a programme 
for study for the coming season ? 

Also, at the same time, why not re- 
solve not to be a "sponge" — taking in 
what others give out, but feeling no re- 
sponsibility to tell others either of your 
successes, failures or problems? Oui 
"letter box" column is available for the 
spread of nursing knowledge of a prac- 
tical nature or for the expression of 
opinion on nursing matters. If you do 
not care to write an article, write a let- 
ter. If you have had a specially diflFicult 
case, tell us about it. If you have prob- 
lems along any line which is likely to be 
of general interest, take time to state 
your problems in a letter. Names will 
not be published without the writers' per- 
mission. Begin now to get out of the rut. 



EDITORIALLY SPEAKING 



245 



A Suggestion in Meclical4|Bducation^ 

One of the newer ideas in medical ed- 
ucaaon, and^ indeed, one of the sanest^ 
has been advanced by Dr. Denny, of 
lirookline, Mass., in the Boston Meaical 
and Surgical Journal. He urges the re- 
quiring of all medical students to spend 
a few months, previous to graduation, in 
actual nursing m the male wards of hos- 
pitals. He would have this term of prac- 
tice to include both day and night duty; 
would have tliem on duty, not as "ob- 
servers," but would place them under 
the strictest discipline in uie warub, 
making them responsible for giving 
every nursing treatment necessary 
ana for the general care and com- 
fort of the patients. He would have 
them taught, just as are probation- 
ers, regarding the administration of 
drugs and remedies of various kinds; 
baths for cleanliness, comfort or remedial 
purposes, enemata — every kind of nurs- 
ing treatment, including bedmaking, etc. 
He thinks the would-be physician would 
in this way secure a knowledge of dis- 
ease and of patients which he would get 
in no other way — a knowledge such as 
no laboratory or lecture or text book can 
furnish. 

There is no dou'bt that humanity would 
be immensely benefited if the medical 
students of the future were required to 
gain experience in the actual daily care 
of the sick. The average doctor thinks 
he knows all there is to (be known about 
nursing. It looks so easy and simple when 
a nurse who has been drilled for months 
and years goes about her daily tasks. 
Just as the average man thinks he knows 
all about housekeeping — thinks it is a 
very simple kind of work — till he starts 
to do it 

Now and again one meets a doctor 
who will own up that he couldn't change 



the bed clothing properly, and certainly 
the young meuicai graduate is apt to 
make a tremendous fuss and a fizzle 
when he attempts some duty whicii he 
has seen the nurses periorm with perfect 
ease. One doctor whom we knew 
argued that it was impossible lo cliange 
tne undersheet oi a bed without gectmg 
cne patient out oi bed. iiut the medicai 
graduate, however much he might con- 
sider desirable the knowledge oi how to 
make the sick comfortable, would not 
scoop to learn nurstny. As a medical 
stuaent ne mignt 'Oe required to do so. 
As a medical graauate he would think it 
beneatn him. nven tne inierne in ins 
year or more oi hospital experience, see- 
ing nursing arts going on all arouna mm 
every day, actually learns little about 
them, ior the art oi nursing is not 
learned by observation, but by actual do- 
ing of the duties— clumsily, at nrst, but 
better and better as the weeks and 
inonriis pass. There is no doutbt that ii 
tnree montns were actually required to 
oe spent m tiie wards, hour after Hour, 
with tlie patients, the medical student 
would carry out from those wards more 
practical working knowledge than he 
would get in a year's classroom work. 
Much of the teaching along medical lines 
seems to take for granted that the doc- 
tor IS going to have a trained nurse at 
ins elbow on every case — though every 
one knows that in nine cases out of ten 
or more he will have to get along as best 
he can with people who could not give 
an enema, a bath, a douche, take a tem- 
perature or prepare and apply a fomen- 
tation properly, to say nothing of the 
all the more careful nursing treatments 
needed in cases of serious illness to tide 
over a crisis. Let us hope that Dr. 
Denny's suggestion will receive serious 
consideration. 



246 



THE TRAINED NURSE AND HOSPITAL REVIEW 



A Private Hospital or Not 

A NURSE who has had considerable ex- 
perience in private nursing and hospital 
work is considering the advisability of 
opening a private hospital and writes for 
advice. In case we advise against it, she 
wants suggestions as to other lines of 
work which a woman with a small 
amount of capital and her experience 
can undertake which will provide a liv- 
ing and help her to secure a home of 
her own. 

This is an exceedingly important sub- 
ject to thousands of nurses. Scarcely a 
week passes in Which we do not hear 
from or meet nurses who, having nursed 
for fifteen or twenty years, would gladly 
make a change to some less strenuous 
occupation. *'What do other nurses do, 
when they give up nursing, providing 
(liey do not marry?" they ask. 

Now, these are questions on which 
nurses themselves are more competent to 
speak and give advice than any one else. 

How can a nurse who has saved from 

« 

$1,500 upward to twice that amount best 
invest it and her strength and experience 
so as to make provision for an inde- 
pendent future? We would be glad to 
hear from fifty or more nurses on this 
subject. Be one of the fifty and write 
your opinion promptly. Do it now.. 

+ 

The Lure of the Uncommon and 
Far Away 

This is the subject of a popular lec- 
ture which has been recently delivered in 
several colleges. The message it carries 
is quite as much needed by nurses, for 
the tendency for some time has been to 
evade (at conventions especially) dis- 
cussion of the weak points in present 



nursing conditions and to spend time on 
questions which have but a remote bear- 
ing on nurses and nursing. 

**In the dim and shadowy past," said 
the lecturer, "up to the shining present, 
there has been a great lure for mankind 
in the uncommon and far away. Men 
were able to calculate ecUpses before 
they could lay out good roads. They 
studied the unusual being instead of the 
child. Science studied the mysterious 
and neglected to study agriculture." 
This mistake has been made, as every one 
knows, in the matter of nursing educa- 
tion as in other lines of education. 

The lecturer emphasized the present 
and the practical, the solution of the 
small problems at our own doors before 
undertaking greater problems which were 
farther away and for which we were 
only remotely responsible. 



infantile Paralysis 

Few nurses have had instruction in 
the nursing of infantile paralysis in their 
hospital training, so our readers are to 
be congratulated on our procuring the 
article in this issue, **Nursing in In- 
fantile Paralysis," by such an authority 
as Dr. Le Cjrand Kerr, of Brooklyn, 
N. Y. 

Dr. Kerr has had every opportunity 
of observing this disease and treating it, 
for he is Visiting Physician to the Chil- 
dren's Wards of the Methodist Episco- 
pal, the Bushwick, the Williamsburg and 
the Swedish Hospitals, Consulting Phy- 
sician to the Industrial Home for Chil- 
dren and the East New York Hospital. 
He treated some sixty-five cases in the 
epidemic of 1909. 



CI)e f|o0pttal B^etitetD 



Baby Tents as Summer Hospitals. 

The Department of Health, Chicago, one of 
the most efficient in this country, has been 
conducting a widespread campaign to save 
the babies this past Summer. Doctors, nurses, 
health officers, interpreters and associated 
workers to the number of about 500 have 
been actively engaged in the hand-to-hand 
fight with the enemies of the babies — dirt, 
overcrowding, bad milk, bad care, etc. 

Eleven baby tent hospitals have been estab- 
lished in congested areas, and are regarded 
by the leaders as "the most important fea- 
tures of the campaign." 

The equipment of the tents consists of a 
hospital tent about 12 by 16 feet, with a double 
roof, board floor and sides, and screen sides 
above the chair rail. Each contains eight 
iron beds, a hammock, electric lights, two 
electric fans and a telephone. There is also 
a receiving tent, about the same size, for ex- 
amining, bathing and temporary care of the 
bab3^ Milk commission milk has been used 
almost exclusively, as a milk depot was main- 
tained at each hospital. The tents are opened 
about July i and closed about September 15. 
The ten\s are kept open nights and Sundays 
only in extreme emergency of either very 
sick patients or severely hot weather, to pre- 
vent the usual "blue Monday," for it was 
noted Monday was the worst day of the 
week. A visiting nurse is in charge of each 
tent, with one or two assistants. When the 
work justifies, an interne spends all day at 
the tent. Every day some physician visits 
the tent. The arrangements are such that 
each physician visits a tent twice a week. 
Only patients under about two years of age 
are received, as those older could not be kept 
in the beds. Only babies of the poor are 
taken. When it can be determined through 
the visiting nurse of the district that the par- 
ents are able to pay they arc referred to their 
family physician. A large proportion of these 
little sufferers are brought in or sent in by 
the district visiting nurse. When patients 
fail to return they are investigated by the 
visiting nurse. 



Why Hospitals Should Be Built in the 

Country.* 

R. W. CORWIN, M. D., PUEBLO, COLORADO. 

To patients who value their lives, to cities 
which care to observe economy, to doctors 
who are conscientious, to all doctors, I might 
say, the objections advanced are: They arc 
inconvenient for doctors; they are incon- 
venient for medical colleges; they are incon- 
venient for families and friends to visit; they 
are expensive on account of transportation; 
they are dangerous on account of transporta- 
tion. 

The advantages are better air ; better light ; 
better food ; better water : more rooms ; less 
noise; quicker recovery; less expense; greater 
advantages to patient, family and State. 
Emergency hospitals must continue to be part 
of a city. This needs no discussion. Let us 
review the objections. 

Certainly no one would claim that the doc- 
tors' or students' inconvenience should be 
considered a valid objection if a patient's 
sufferings thereby were prolonged or in- 
creased. 

Every doctor dreads visitors, the effect 
upon the patient is nearly always bad; in 
fact, it would be a blessing if family and 
friends were not near the hospital. 

Expense of transportation would be more 
than balanced by shortening the time of the 
patient in the hospital, due to country en 
vironment. 

The danger of transporting a patient out 
of a city is no greater than transporting him 
into a city. The latter is common and not 
feared. Why dread the former? 

If not in condition to travel, place him in 
the emergency hospital until able to stand 
the journey. 

Commenting upon the advantages, who will 
say that country air is not superior to city 
air? Who will not say that patients stand 
better chance of life and improve more rap- 
idly in bright sunlight and clear atmosphere 
than in sunless, smoky, closely packed and 



*Read bsfore oooventloii of RftUroed Surgeons. 



248 



THE TRAINED NURSE AND HOSPITAL REVIEW 



noisy cities, where oxygen is many times 
breathed, and to get any at all one must seek 
a roof garden surrounded by a wire fence, 
flanked by brick walls and chimneys, with 
clotheslines, flying shirts and skirts for land- 
scape ? 

In the country land is inexpensive and 
crowding of patients inexcus^able. Here* pa- 
tients may be kept out of doors; fresh farm 
foods are obtainable, milk, butter and veg- 
etables, and, not least of all. Nature is always 
present and ready to assist the doctor and 
nurse in restoring health. The flowers, the 
grass, the woods, the birds, are God's reme- 
dies not to be overlooked. 

Under equal conditions the sick are not 
only surer of recovery, but recover more rap- 
idly. This is of no small item to the patient. 
It not only saves him suffering, but is impor- 
tant in giving him an opportunity of gettmfe 
back to work sooner, of earning more for his 
family, and of being of greater value to his 
country. 

Is there an excuse one can mention that 
prevents us from lifting our voice against 
the city hospital? 

It is not only better for the patient, but 
better for the doctor, to live in the country. 
He will think quicker, clearer, and live 
longer. Some one says: "Patients will not 
go to the country." Nonsense ! They go to 
the Adirondacks, to Rochester (Minn.), to 
Arizona, to California, to Europe, to Egypt. 
Of course, patients will go to the country; 
gladly go when told of its advantages. The 
rich already go; the poor will be pleased to 
follow when they understand. 

Why do we not build all hospitals except 
emergency hospitals in the country instead 
of the city? The answer is, because our city 
fathers are ignorant of facts ; doctors are 
unconsciously selflsh, and patients have not 
been educated. 



Morton Hospital. 

In the annual volume of the Morton Hos- 
pital, Taunton, Mass., there appears this beau- 
tiful tribute to the late Miss Ella Sears, who 
was for nineteen years superintendent of the 
hospital and who left the scene of her earthly 
labors October 2, igog: 

"Miss Sears was a woman of remarkable 
executive ability, combined with rare judg- 



ment, unwavering faithfulness, ceaseless thor- 
oughness, economic shrewdness, orderliness 
and neatness in the extreme. 

"She showed great tact, but an undaunted 
will; wondrous courtesy, but cxhaustless pa- 
tience; extreme delicacy of personality, yet an 
insurmountable boldness in action; self-for- 
getfulness, yet constant thoughfulness for 
others; an abiding faith and an unfaltering 
trust 

" 'Like one that wraps the drapery of his 

couch 
About him and lies down to pleasant dreams.' 

"Miss Sears was ideaflly optimistic; if there 
were 'shadows in the valleys,' she was equally 
sure there was 'sunshine on the hills;' true as 
steel, with never a thought of divulging that 
committed to her; honest to the innermost 
fibre, nearly a score of years superintendent, 
yet there never came to the trustees the sha- 
dow of a question of distrust. 

"Miss Sears won and continued to hold the 
regard of all. 

" 'None knew her but to love her.' 

"This institution has lost a wise ruler; 
trustees and staff a loyal friend; nurses and 
employes an unfailing support; patients and 
friends an inspiring voice; church, city and 
village home a hold, courageous, yet a none- 
intrusive life for the right." 

Two Ella Sears Memorials have been pro- 
posed. One is, pay the debt which troubled 
her, and the other, erect the wing which she 
longed for and which the hospital greatly 
needs. 

+ 

Paterson General Hospital. 

Within the past year the Paterson General 
Hospital, N. J., has received a notable gift, 
amounting to forty thousand dollars, to be 
used in the erection of a nurses' home. The 
donor is Mr. Peter Quackenbush, a member 
of the Board of Managers, who thus per- 
pduates the memory of his wife, Sarah 
Amelia Quackenbush. The gift is made con- 
ditional on the creation of an endowment 
fund of not less than eight thousand dollars, 
the income of which is to be used for the 
maintenance and repair of the building. The 
plans provide for a building with three stories 
and basement, with a solarium on the roof. 
It is Colonial in style, of tapestry brick with 



THE HOSPITAL REVIEW 



249 



limestone (rimmjngs and portico. Every de- 
tail that would make for the comfort of the 
nurses seems to have been planned for. The 
installation of an ice plant has resulted in a 
substantial saving, besides providing for the 
better care of meat and perishable foods, the 
cooling of the mortuary box, and meeting all 
the needs for ice throughout the institution. 
.Another imporiant saving has been effected 



Brockton Hospital. 
Some one has said that the modern hospital 
is partly outside and partly enclosed by walls. 
To have this thought emphasized one needs 
to visit New England hospitals in the Spring, 
Summer and early Fall. He will find a large 
proportion of the patients out of doors. This 
has necessitated a large amount of planning 
in order to have the patients made comfort- 



R.\DUATING CLASS, I9IO, KANE SUMMIT HOSPITAL, KANE, P.\. 



through a iii'w plan for the distribution of 
surgical gauze. Bi'Iicving that the consumption 
of gauze was unusually lar^c. an investigation 
was made and change in methods inaugurated. 
.\ reduclioii of llfiy pir i-cni in the amount 
of gau^e used has been made. 

The daily average of patients was 100,7, the 
number treated duriuR the year, 2.oog, and the 
cost per day per patient, $1.64. 



able while getting the benvfil of iht open-air 
treatment. Among the improvements made al 
the Brockton Hospital, Mass., hat been the 
erection of Iwo piazzas, which were made 
possible through the generosity of Mr. D. W. 
Field. A gift of a "service building," from the 
same gentleman, has been gratefully accepted. 
There is urgent need of an emergency room 
in the centre of the city and of increased ac- 
commodations. 



250 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Notes and News. 

At Buffalo General Hospital there has been 
established one of the finest i>athological la- 
boratories in this country. It is the gift of 
Chas. W. Pardee, president of the board, and 
is called the Pardee Laboratory. It occupies 
a series of eight rooms and is under the gen- 
eral direction of Dr. B. T. Simpson. 



A $50,000 addition is being made to the 
Northern Pacific Beneficial Hospital at Ta- 
coma, Wash. 



The Elizaibefib Steel Magee Hospital at 
Pittsburg has acquired additional property and 
buildings to cost $250,000 are to be erected. 
It is intended to make the Elizabeth Steel 
Magee Memorial Hospital unique in the beau- 
ty of its grounds and the quietness and peace 
which will be provided for patients. 

The providing of extensive grounds and 
the breathing space which so many hospitals 
lack has been the first thought of the direc- 
tors. The hospital will have wliat every other 
hospital in Pittsburg lacks — a beautiful park 
where convalescents can spend the day on 
beautiful stretches of lawn under great spread- 
ing trees, flanked by shrubbery. 



Dr. E. E. Langley has established the Har- 
rington Hospital at Harrington, Wash. 



Through the generosity of Mr. A. G. Ham- 
ilton, the citizens of North Sydney, Nova 
Scotia, have the benefits of a hospital. It is 
called the Hamilton Memorial Hospital and is 
conducted by the Sisters of Charity. 



The American Steel and Wire Company is 
erecting a hospital on its own ground for the 
care of injured employes. 



Rochester, N. Y., is to have a children's 
hospital. Plans have been drawn for a build- 
ing 55x75 ^eet. 

A $30,000 addition is to be made to the 
General and Marine Ho'spital at Owen Sound, 
Ont. 



At the General Memorial Hospital, New 
York, 1,139 patients were treated last year. 
The receipts amounted to $56,445.02. Of this 
amount there was paid to special nurses 
$8,444.73. 



St. John's Hospital, Lowell, Mass., has com- 
pleted its forty- second year of work, during 
which it cared for 883 patients in the wards 
and rooms. Many improvements have been 
made, a pathological department has been es- 
tablished. Additional accommodation is great- 
ly needed. 



Dr. L. W. Luscher has been appointed su- 
perintendent of the City Hospital, Kansas 
City, Mo. 



The new hospital at Waterbury, Conn., to 
replace the old building, is going forward 
rapidly. 



Mrs. Whitelaw Reid will erect two addi- 
tional buildings for the Red Cross Guild Hos- 
pital of San Mateo, Cal. 



A modified milk station has been opened in 
connection with the dispensary of Mt. Sinai 
Hospital, N. Y., to be maintained throughout 
the year as a part of the gencrs^ plan for the 
better care of babies. 



Misses Marshall and Cook have opened a 
hospital at Orangeburg, S. C. The building 
formerly a large dwelling, is beautifully situ- 
ated and well equipped. 



Training schools arc to be opened in con- 
nection with the State hospitals at Rock 
Springs and Sheridan, Wyoming. A two-year 
course will be established, and pupil nurses 
will receive $10 a month, uniforms and living 
expenses. 



The new addition to Harper Hospital, De- 
troit, has been decided on, and work will be- 
gin at once. Two hundred thousand dollars 
is to be expended in improvements. 



Jfn tl)e Ctamms ^ct)ooI 



CONDUCTED BY CHARLOTTE A. AIKENS. 



The Education of Nurses 



MARY E. GLADWIN. 



In spite of all that has been said and writ- 
ten on the subject of the education of nurses 
we seem not much nearer the end of our 
dfifTicuIties and differences. Perhaps our 
greatest hope lies in the fact that we realize, 
as never before, how great our difficulties are 
and how much work lies before us. The 
tendency in present-day methods was very 
well expressed at a New York meeting last 
winter. In discussing a paper on the teach- 
ing of anatomy and physiology, a prominent 
educator, whose least word always carries 
weight, said, with much emphasis, that a 
pupil nurse's study of the subjects under dis- 
cussion should always begin with a thorough 
study and use of the microscope. At the 
same meeting one of the New York board of 
examiners voiced a criticism often heard out- 
side our ranks but seldom within them. She 
said that the results of the examinations 
seemed to show a tendency to dwell too much 
on what are sometimes known as "fancy 
"^ stunts in nursing," to the neglect of a con- 
sideration of the comfort of the patient. 

It is hard to find a happy mean with the 
knowledge that the high school regulation 
shuts out many desirable women and the 
added knowledge of how patients sometimes 
complain bitterly of the intellectual barren- 
ness of the nurse upon whose companionship 
they are dependent during a long and tedious 
convalescence. The hospital of to-day makes 
ever greater calls upon the nurse's intelli- 
gence and fertility of recourse, hospital appli- 
ances have become more and more costly 
and delicate, requiring much trained ability 
for their successful use. For her own sake, 
that she may have a sure source of inspira- 
tion and comfort to keep her sane and whole- 
some during the long days of hard labor and 
discouragement which are bound to come to 



her in her work, we long to give every nurse 
a sound, general education. Nevertheless, 
the time has come when we are driven to a 
thoughtful consideration of how much time 
we can spare from the bedside study and 
practice of nursing for class and lecture 
work. Personally, I should feel cut off from 
a great source of interest and help in my 
work if I had no knowledge of chemistry and 
bacteriology, and yet I grow more and more 
doubtful of the utility of the hours pupil 
nurses spend in pursuit of these and kindred 
subjects. 

Primarily, nurses are trained to care for 
sick bodies and sick minds. Training schools 
were founded and have grown with that ob- 
ject in view and that alone. The two or three 
years of hospital work and teaching have 
for their sole object the fitting of young 
women for the care of the sick. The purpose 
of these years is not to train superintendents, 
executive officers, social welfare workers, 
teachers or any of the other workers to whom 
avenues of usefulness are continually open- 
ing, but just nurses, plain every-day nurses 
to do nursing. That being understood, the 
rest ought to be much easier than it has 
proved to be. We all agree that we want 
women of refinement, ability and the best pos- 
sible education. The only question is as to 
what shall constitute their training after they 
are once within the hospital walls. 

A Boston surgeon, lecturing to a class of 
nurses, surprised them by saying that if he had 
to choose he would prefer a nurse who knew 

§ 

a few ways of dressing hair to one well 
grounded in anatomy and physiology. Expe- 
rience has taught many of us that a knowl- 
edge of how to read aloud well and an ac- 
quaintance with current novels and current 
events has contributed much more to the sue- 



252 



THE TRAINED NURSE AND HOSPITAL REVIEW 



ccsS of a nurse than much study of bacteri- 
ology. Osier quotefi from Froude: "The 
knowledge which a man can use is the only 
real knowledge, the only knowledge which has 
life and growth in it. The rest hangs like dust 
above the brain or dries like rain drops off 
the stones." 

You may condemn my view of the mattei 
as narrow and utilitarian, savoring of the 
spirit of modern industrialism, but I believe 
that our education is often in the wrong di- 
rection and that we sometimes pay too dearly 
for it. If the nurse comes to any study utterly 
weary in body and mind, if sh€ must forfeit 
rest and recreation in its pursuit, if her pa- 
tients must lack systematic and intelligent 
care, then the cost is too great. After all, 
nursing the sick isn't learned in the classroom, 
and the majority of nurses see ,very little 
relation between what they there hear and the 
actual ward work. We learn nursing at the 
bedside of the patient in his actual care under 
constant and careful supervision. When, with 
minds full of the crowded duties of the day, 
superintendents and teachers forget that the 
immediate care of the sick is not the primary 
object of a school, nursing is not well learned. 
Jt isn't learned in the mad rush of many of 
our modern wards, with no ward teaching ex- 
cept that of a liead nurse too hurried to give 
more than a breathless order. The ward 
teaching sometimes reminds us of the prac- 
tical methods in vogue in Dickens's Dothe- 
boys' Hall. 

A practical, able, overworked superintendent 
of nurses, showing a visitor through the 
wards, stopped to explain various appliances 
on a little tray planned to make the taking 
of temperatures eminently safe and scientific. 
During the explanation the visitor's eyes fol- 
lowed the movements of a nurse taking tem- 
peratures on the other side of the wards and 
saw her violate every one of the rules the 
little tray was meant to make easy and prac- 
ticable for her. 

Nursing is not well learned when a pro- 
bationary period, during which the ward work, 
for the most part taught by a fellow pupil 
of little more experience, is followed by a 
junior year, which is one mad rush of things 
once shown, facts imperfectly digested, and a 
vain seeking for the reasons of much doing, 
and is finally crowned by a senior year of re- 



sponsibility, for which she receives no special 
training and for which she is unfitted. 

If we are honest, we must confess that the 
patient as a human being plays very little part 
in the thought of the nurse in training. His 
comfort is not the centre of her many activi- 
ties. Just to the extent that her work is done 
per se and not with the patient in mind, is it 
done unintelligently, and it is the source of 
more than half the friction between patients 
and nurses and between doctors and nurses. 
We can hardly wonder at results when wo 
study existing conditions. There are seldom 
enough nurses to do all the work required. 
The strain upon the head of many a school in 
trying to divide an inadequate force so as to 
cover deficiencies is tremendous. The working 
time of the pupil is so divided by class, dem- 
onstration, lectures, examinations, hours off, 
that she hardly knows what it is to have in- 
dividual patients. An intelligent study of the. 
patient and his needs is not possible to her. 

Jane Addams's article of a year or two ago 
on the point of view of the patient in the 
hospital conveyed much truth and deserved 
much more study and thought than it seemed 
to receive. Is there any head of a school who 
has not heard a patient say: "I try not to ask 
for anything, the nurses are so busy''? There 
are so many things to be borne in mind. The 
spreads must be tight and tidy before the su- 
perintendent of nurses comes; the shades 
must reach the line approved by the superin- 
tendent; the chart must be in order for the 
visiting doctor; the linen folded before the 
head nurse comes back from her hours off. 

A doctor coming out of a ward said to me : 
"What is the matter with that woman? Can't 
she see that the wind blows directly on Mrs. 
Cole, operated upon this morning, and that 
Mrs. Irwin is trying vainly to get away from 
the sun shining directly in her face?" The 
trouble with tlie nurse was that she was worn 
out. She was trying with aching feet and tired 
brain to do two women's work and was fast 
losing that keen, vivid interest and joy in her 
work with which she started, and the added 
pity is that all her future work will suffer 
from this lack of cultivation of her perceptive 
powers. Her ambition to cover all the ground 
possible is often the undoing of the nurse, and 
later means much suffering to herself and 
much lack of comfort to her patients. Her 



IN THE TRAINING SCHOOL 



253 



first year of private duty is often a time of 
great chagrin, which gives some inkling of all 
that she has missed. 

The teaching the pupils need, and the 
teaching the patients and wards show that they 
need, is bedside teaching — not one showing 
how to do a thing, but constant, daily instruc- 
tion and oversight, with time to cultivate that 
spirit which Christ showed when he washed 
the feet of the disciples. 

All of which brings us very naturally to a 
consideration of the teachers of nurses. With 
the growth of the school of to-day, and the 
increased work and responsibility, that close 
personal contact of the head of tfie school 
with the pupil, that personal contact which 
made so valuable the work of earlier days, 
has been largely lost. It sometimes happens 
that the head of the school is aln^ost a 
stranger in the wards. We are only just be- 
ginning to realize that the admirable qualities 
which make a woman a good executive head 
of a department or institution do not, of ne- 
cessity, make her a good teacher; and, that 
teachers of nurses need as careful a training 
in teaching as the teachers of children. Every 
large hospital receives yearly applications for 
nurses for executive positions. The best 
available graduate is sent, and, thus it hap- 
pens that scores of young women go out every 
year to do such work, in spite of the fact that 
they may never have held a single recitation 
or received the slightest instruction in the 
methods of so doing. In addition to which, 
they often have not the faintest conception as 
to how to buy hospital supplies or how to keep 
hospital accounts. For this lack of prepara- 
lion the nurse pays in worry, anxiety and 
needless mistakes, while the loss to the insti- 
tution and to those under her it is impossible 
to estimate. 

It is a great economic waste that all our 
large schools and even our schools of mod- 
crate size are not doing post-graduate work. 
The demand for it grows every day. An ever- 
increasing number of nurses is seeking addi- 
tional training. Nurses from small hospitals in 
small towns who desire to broaden their out- 
look by contact with nurses from other schools 
and by a glimpse of life in cities; nurses who 



have done private work for a long time and 
now desire to brush up generally; nurses de- 
siring new surgical methods; nurses seeking 
executive positions; nurses who desire to fit 
themselves for visiting nursing or social wel- 
fare work. For whatever reason they enter a 
post-graduate school, their fate is similar — 
they are put together, the round pegs getting 
into square holes, to learn in the old way 
largely by observation and doing, but they are 
seldom or never classified and they receive 
nothing like systematic, definite, daily instruc- 
tion by a trained teacher in that specialty 
which they desire and have often made con- 
siderable sacrifice to obtain. A special hospi- 
tal built for special needs, confronted by the 
necessity of caring for its sick, gives her many 
valuable lessons, but it is impossible to classify 
such students or to give them what they seek. 
In a large general hospital, or even in one of 
moderate size, the material is ready, waiting, 
and the work can be done greatly to the ad- 
vantage of the hospital. The one thing lacking 
is usually the teacher. The old difficulty crops 
up constantly, the tendency being to place the 
nurse in a department to pick up haphazard 
what she can — an extremely wasteful process. 
With the work outlined, systematized, and in 
the hands of a practical teacher, with time to 
devote to it, the gain to everybody concerned 
would be very great. 

Small hospitals, neighbors in thickly settled 
districts, could gain very much by having a 
supervising teacher in common, who should 
spend her time in going from hospital to hos- 
pital, and in having regular meetings of all 
the teaching head nurses or supervisors. 

We need not only regfular teachers' meet- 
ings like those of our public schools, but we 
need something like the yearly institute of the 
public schools, which calls together all the 
teachers of a cotmty for a comparison of 
methods and work. Think of the glorious 
work and opportunity for our nursing organi- 
zations when they once realize that general 
meetings are wasteful in the extreme and that 
sectional work, so arranged that each nurse 
may find help in her own specialty, is the ideal 
way. 



Book B^ebtetDd 



The coming book, "Hospital Management: A 
Handbook for Hospital Workers" on which, 
for two years, Miss Charlotte Aikens has been 
working, is now in press and will be issued 
this fall. Miss Aikens has planned and edited 
the volume, to which about fifteen of the 
prominent hospital workers of this country 
and Canada have contributed chapters. The 
volume will be of convenient size, well illus- 
trated and thoroughly practical from cover 
to cover. It is sure to find a cordial wel- 
come when it issues from the press. 



Preventable Diseases, By Dr. Wood Hutch- 
inson. For sale by Lakeside Publishing Com- 
pany. Price, $1.50, post paid. Nurses who 
read the popular magazines need no intro- 
duction to the writer of this volume. Dr. 
Woods Hutchinson has done much in recent 
years to popularize the study of preventive 
diseases on the part of the laity by his 
breezy and vigorous articles on medical sub- 
jects. 

In this volume there is a vast fund of 
information and practical health suggestions 
written in a style that is readable, interest- 
ing, almost fascinating. Some of the subjects 
treated are: "The Body Republic and its De- 
fense"; The Physiognomy of Disease: What 
a Doctor can tell from Appearances"; "The 
Natural History of Typhoid Fever"; "Ade- 
noids, or Mouth Breathing: Its Cause and 
its Consequences"; "Tuberculosis, a Scotched 
Snake"; "The Herods of our Day: Scarlet 
Fever, Measles, and Whooping Cough"; "The 
Great Scourge: i. e.. Pneumonia and its 
Cure"; Xolds and How to Catch Them"; 
"Treason in the Body: The New Theory of 
Cancer"; "Nerves and Nervousness"; "Ap- 
pendicitis: Nature's Remnant Sale"; "Ma- 
laria: The Greatest Foe of the Pioneer"; 
"Rheumatism: What It Is and Particularly 



What It Isn't"; "Headache: The Most Use- 
ful Pain in the World"; "Diphtheria, The 
Modern Moloch : Offering up a Guinea Pig 
for the Life of a Child"; "Mental Influence 
in Disease; or. How Does the Mind Affect 
the Body?" 

As a volume of required reading for a 
class of probationers, there could be no bet- 
ter. As a book to be picked up when off 
cases, to freshen up one's knowledge, it is 
so far as it goes, unexcelled. Nurses, doc- 
tors and patients might profitably own and 
read this volume. 



Practice of Osteopathy, its practical ap- 
plication to the various diseases of the human 
body, by Charles H. Murray, A.B., B.D., D.O. 
Illustrated with 108 half-tone engravings. 
Price $2.50. For sale by the Lakeside Pub- 
lishing Company. 

It is difficult to review with fairness a work 
on a subject on which one is skeptical. 

While we believe in the value of deep mas- 
sage in many cases, we do not believe that 
osteopathy will be of much help in many of 
the diseases mentioned in this work as curable 
by it. 

However, our personal bias aside, if you are 
an osteopath, or if you want to become posted 
on osteopathy, here is a good book for you 
to read. 

It is printed in large, readable type, and, as 
above mentioned, has 108 half-tone engrav- 
ings, and the work will certainly give you a 
clear insight into osteopathy as it is presented 
to the public to-day. Probably no serious and 
well intentioned book has yet appeared from 
which an equally serious and well intentioned 
student could not derive much value, and we 
feel sure this is the case with this work. At 
any rate, it will .certainly be a useful book for 
the osteopathic disciple. 



€Jt €tiitor*s iLetter=bojc 

THE EDITOR IS NOT RESPONSIBLE FOR THE VIEWS OF CONTRIBUTORS 



Private Nursing in Rome. 

To the Editor of The Trained Nurse: 

You asked me long since to write some- 
thing about private nursing for the American 
Graduate in Rome. It can be summed up in 
a few words and the following advice might 
cover the whole outlook: That I heartily 
discourage any nurse from the idea of find- 
ing enough to do to keep her. This may seem 
a strange statement to make, but the trained 
nurse is an unknown quantity in the Italian 
home, the home that corresponds to the 
American home, and it is even of rarest oc- 
currence that a nun is called in to minister 
to the needs of a sick member of the family, 
even among the well to do classes, the idea 
being that discredit would fall on the rest 
if a stranger were called in to perform what 
to them are simple duties. Perhaps, this is 
only another evidence of the love of family 
which exists to such a strong degree in Italy. 
Among the foreign colonies in Rome, or 
among the traveling tourists, a nurse might 
occasionally be called to a case, but this work 
is very casual and uncertain, and usually 
restricted to the three Spring months. Feb- 
ruary, March and April, which to persons 
not thoroughly acclimated is a treacherous 
time of the year and colds often turn to 
pneumonia. I have spoken with several 
nurses who have had the courage to try 
their fortune in this city and from not any 
one has there come an enthusiastic reply; a 
hard fight for most if not for all, and after 
a certain venture they are glad to return 
home, sadder and wiser. It meant living in 
Rome at great expense while waiting after 
paying the customary round of calls on the 
physicians. And it is not here as at home, 
where a nurse settling in a strange place waits, 
yes, for her first call, and perhaps long 
enough to get blue and discouraged, but af- 
ter it comes may consider herself practically 



launched if she does herself credit. Here 
a nurse receives her first call and in it she 
enjoys tthe satisfaction of the unusual, for if 
she is ever lucky enough to receive another 
it is probably after a lapse of weeks. 

Two foreign nursing bodies exist in Rome 
that monopolize between them what nursing 
there is to do. The first is the "Anglo- 
American Home," a small sized and well 
equipped hospital situated on tthe outskirts 
of the city, and the other is a large Roman 
Catholic Convent of an English order of 
sisters. "The Little Company of Mary," who 
have accommodation for a large number of 
patients. They send out sisters in answer to 
outside calls, and as their fee is quite a nomi- 
nal one, they are much in demand. The 
"Anglo-American Home" also has a com- 
petent staff of nurses, all English, sufficient 
in number to attend to the patients and to 
answer calk. Both these institutions are 
largely patronized by the foreign physicians. 
It is easily seen how a nurse steering her 
career alone, if she gets any work to do, it 
consists only of the overflow the two institu- 
tions cannot take care of, and this overflow 
occurs during the season above mentioned. 

The "Anglo-American Home" is supported 
by both English and American contributions 
and donations, and is intended for those Eng- 
lish and American residents or visitors in 
Rome, who, falling sick, wish to be cared 
for in a hospital. The staff of nurses, how- 
ever, whether by accident or intention, are 
all English. Rumor has it that the directress 
of tlic home was heard to observe that they 
had no need for American nurses there, but 
gossip holds sway at times in the Eternal 
City. 

This report covers the present and past situ- 
ation as regards private nusing in Rome. That 
the future may hold more scope for it is pos- 
sible now that a training school for nurses h^^ 



256 



THE TRAINED NURSE AND HOSPITAL REVIEW 



been started, with a small beginning in con- 
nection with a part of the Polyclinic. 

Phyllis S. Wood. 



In Reply to Miss Barclay. 

To the Editor of The Trained Nurse: 

In the August number of your magazine 
Miss Anna W. Barclay sees fit to take me to 
task about some things I did not say in my 
recent article on "S. D. A. Nurses." She" makes 
me seem to carry the idea that the nurses un- 
der consideration act independently of the phy- 
sician who gives them employment. I have 
since reread my article in some alarm lest I 
really did convey that impression in my re- 
marks, but was speedily reassured, for nothing 
of the kind appears in the article. In fact, I 
could not go nearly so far as my critic went 
when she said: "From the beginning of nurs- 
ing, nurses have had to give treatment under 
a physician's order which they, perhaps, did 
not approve." 1 could not go quite so far as 
that, for it is generally understood that the 
doctor knew about as much about the case as 
the nurse. 

What T desire to convey by my remarks is 
that there arc occasions and circumstances in- 
numerable where the trustworthy nurse is 
given her own way to treat (not medicate) 
the case largely at her pleasure and in her own 
way. There are many times and oecasic ns 
where emergencies arise and something must 
be done immediately. I have never heard of 
a physician criticising a nurse for such use of 
the measures mentioned when used to meet an 
emergency suddenly arising in his absence. 
Then there are times that the nurse is sent to 
the country alcne to carry along a case of 
fever or some chronic disease. I myself have 
had such experience more than once and was 
given instruction by the doctors that sent me 
to see what could be done by our methods. 
S. D. A. nurses are constantly filling such 
calls, and it is up to them to be able to meet 
this demand. 

Nurses, any nurse, should so hold the con- 
fidence of her employing physician that she 
will be given her way largely in the care of 
ordinary cases. When a doctor gives minute 
orders and instruction in the care of common 
cases, he does it because he does not have ex- 
plicit confidence in the nurse's ability to do 



her part of the work without such orders. Of 
course, when the nurse is strange to the doc- 
tor, this may not hold true. But I have found 
in my few years' experience that most doctors 
exercise the, at least, usual intelligence of man- 
kind in reading the character and ability of his 
helper. A doctor does not, as a rule, care to l)e 
a tyrant over his nurses and dictate just when 
and how she does the myriad little services she 
may do for her patient. It is in these things 
the up-to-date nurse may make use of the 
methods mentioned in the article Miss Barclay 
laid under criticism. 

One thing more, Madame Editor: S. D. A. 
nurses, in common with all others, recognize 
that when working for a physician the respon- 
sibility from a moral standpoint does not ex- 
tend to what the physiciun may do or not do. 
When a drug is ordered, the responsibility is 
the doctor's, not the nurse's. And when the 
doctor learns that you can make use of ra- 
tional measures, he does not use his prescrip- 
tion blank nearly so often, and, I may be per- 
mitted to say, the patient as well as the nurse 
is the gainer. 

Not to make unfavorable comparison nor 
to criticise others was the article written, but 
to encourage advancement in the profession — 
an advancement that is more than such in 
professional maimerisms or financial gains, 
but that we may advance in real usefulness 
was the article written. Very kindly, 

James D. Montgomery. 



Chanute, Kansas. 

To the Editor of The Trained Nurse: 

A little more than a year ago I wrote a let- 
ter concerning the nurses' problem as to lo- 
cating, and unwittingly asked for persona! 
correspondence. I received numberless let- 
ters, so many it was impossible to answer 
them all. 

One nurse from the far East came and 
helped me in my little hospital for a few 
months and has been very busy doing private 
duty ever since. We are needing more pri- 
vate nurses now. The interest in trained 
nursing is rapidly growing, so also is our 
hospital work. Our work of the last year 
has been double that of the year before. We 
are needing more nurses in the hospital, and 
can scarcely ever find an idle nurse when we 



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258 



THE TRAINED NURSE AND HOSPITAL REVIEW 



want one. I am sure a few more nurses 
might do well in Chanute. What is true of 
Chanute doubtless is true of many other 
Western towns. 

If nurses looking for such a location care 
to write me further in regard to Chanute, I 
will answer a few, making selection from 
those I may receive. I would be glad to answer 
all but know that would be impossible, un- 
less I should do so by a detailed letter in 
The Trained Nurse, and that would require 
more space than you have to spare. 

Thanking the editor for giving me space at 
all, I am, sincerely, 

L. Ellen Harrison, 
Supt. "Harrison Hospital." 

Chanute, Kans. 

Reply to Replies. 

To the Editor of The Trained Nurse: 

I know Miss Aikens has not directly advo- 
cated giving doctors control, but I claim that 
the logical outcome of having them on our 
boards will be that very thing. What other 
object could they have in view? Once upon 
a time they were just as unwilling to trust us 
to own and operate our directories, but their 
opposition is fast dying out since their fears 
have proved groundless. 

I do not doubt for a moment that there is 
dissatisfaction in every State regarding its law 
for registering nurses. We would have been 
marvels indeed could we from the start, 
have framed laws exhaustive, final and accep- 
table to all concerned. 

But the particular dissatisfaction it is essen- 
tial we should investigate now is this which 
is attributed to the physicians, who object to 
boards composed entirely of nurses. In how 
many of the seventeen States having such 
boards did physicians take the matter up with 
the committees to whom the nurse bills were 



assigned? What were the arguments they of- 
fered in support of their claim to representa- 
tion? What were the arguments the nurses 
used to combat these claims and to convince 
the legislators it was right and proper for a 
nurse board to be composed of nurses, and 
nurses only? 

If we could get at these additional "facts," 
they might help us all to reach sounder con- 
clusions. For my part, I should like to have 
this topic find a place for discussion at all the 
next annual meetings of the medical societies 
— State, sectional and National — ^and have the 
reports of both the majority and minority 
published, that we might have an opportunity 
to consider all the pros and cons. 

So far, all the reasons given in support of 
the doctors' claim strike me as either trivial, 
specious or illogical; and I am satisfied that 
if all the nursing in the United States were 
done by male nurses, never a word would we 
hear of doctors serving on nurse boards; and 
also if all our druggists were women, then 
there would be an outcry to have physicians 
on State boards of pharmacy ! 

Whatever jurisdiction a physician has over 
nurses is confined either to the individual 
nurse, as a private duty nurse, or to a group 
of nurses, those in a ward, or to some special 
department worker. When a nurse's connec- 
tion with a case, ward, or special work, termi- 
nates, the physician's jurisdiction over her 
ceases. In other words, he has no right to a 
voice in the corporate life of nurses. 

As to having hospitals represented on our 
boards because the status of hospital schools, 
is considered by them, supposing hospital 
authorities were to build and support medical 
schools for supplying their institutions with 
physicians and surgeons, would such logic (?) 
be applied acceptably to medical boards of 
examiners? An Ex-Examiner. 



Persoital. 

Miss Edith Willis has accepted a position as Miss Myra M. Sutherland, superintendent of 

superintendent of the Epworth Hospital at the Corning, N. Y., Hospital, has tendered her 
South Bend, Ind. resignation. 



Miss Sadie L. Jean and Mrs. Mary Sims, 
school nurses at Baltimore, Md., have been 
engaged on duty in the playgrounds of the 
city during the Summer. 



Miss Luella McAlpine, formerly operating 
room nurse at Columbia Hospital, Pittsburg, 
Pa., has accepted the position of superinten- 
dent of Greely Hospital, Colorado. 



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WORKS 
WITHOUT 
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ARTICLES IN THIS DEPARTMENT, WHETHER BEARING SIGNATUSB 01 NOT, ARE CONTRIBUTED, AND 
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MassachusettB.Hc 

Miss Ayer: I was reminded of what our 
register says down at Providence. I ask her 
very often if there is very much demand for 
attendants in the cheap kind of nurses. She 
says there are always a few who take them, 
but she says there is always a great deal of 
complaint — the woman who takes care of the 
mother and baby and does the work, I sup- 
pose that must be what they mean by the do- 
mestic nurse. She says that there are not more 
than three or four women to fill that kind of 
a place. 

Dr. Palmer: May I ask if those three or 
four women are not pretty constantly em- 
ployed ? 

Miss Ayer: They say there are times when 
they are in demand. It just depends on the 
needs of the public, but there may be a time 
when there is no dematid; depends simply on 
circumstances. And probably the district 
nurses do more of what the old-time nurse did. 
They go in and wash and dress the baby, and 
follow it up, so that fills a good deal of that 
need among the more needy classes. 

And the remark about what we were going 
to do to improve our training schools. I think 
our fundamental question is how to secure 
the best possible applicants. There is a very 
old but homely proverb that "You can't make 
a silk purse out of a sow's ear," and it is just 
as true about making nurses out of poorly edu- 
cated material, or material that is under grade 
physically or mentally. I suppose if you talk 
with any one in any special line of work, 
whether educational, industrial or hospital, 
they will have the. same story to tell — that 
they haven't enough good material to fill the 
positions. There never was a greater demand 
than there is at the present time for educated 
women; with the amount of preventive work, 

♦Continuation of the report of the tenth semi- 
annual meeting: of the New England Associa- 
tion for the Education of Nurses, the sulbject 
under discussion being the training school re- 
port of the Hospital Association. 



with the amount of actual teaching, where 
there is a greater demand for nurses to fill 
that class of position — and yet there isn't 
enough material to fill the positions satisfac- 
torily. And I think probably they are having 
to accept grades of women that are not up to 
their standards — they have to take them from 
the material which they have. And the same 
thing with our training schools, with our posi- 
tions for nurses — it isn't altogether the fault 
of their opportunities. We always know wc 
graduate a great many young women who 
have not lived up to the opportunities that 
they have had; it wasn't perhaps that they 
didn't want to. You have got to have some 
basis of good home training, got to have a 
fairly good mind, and educational opportuni- 
ties; you can't expect to supply all these in 
three years. The great trouble is that there 
is too much expected of the training school — 
we don't go back far enough! 

Dr. Washburn : I was interested in what 
Miss Ayer just said. I have been very much 
impressed recently with the dearth of ma- 
terial to fill higher positions in the training 
school — the lack of women with sufficient ed- 
ucation and culture to be put in the responsi- 
ble positions of the great modern hospitals. 
We intend to make a distinct effort at the 
Massachusetts General Hospital to make our 
course sufficiently attractive so that we will 
be able to get more women of education. One 
way which we are about to start is to increase 
our numbers so that we may shorten our 
hours. It has been the story, I think, in the 
past whenever we have approached college 
graduates and suggested to them the oppor- 
tunities open to a trained nurse they have been 
frightened by the length of the hours of 
work. We hope to remedy this by shortening 
our hours. We intend to make our course in 
training more attractive in other ways. 

Dr. Cook: I do want to say a word for the 
small hospital — one phase or two phases that 



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262 



THE TRAINED NURSE AND HOSPITAL REVIEW 



have been alluded to. There is no question 
but what much that has been said about the 
small hospital and the inadequacy of the train- 
ing given is true, but I don't know that whole- 
sale condemnation of it is true, and I believe 
that a small hospital can be so equipped and 
have such a superintendent and assistant 
superintendent and head night nurse and 
others, that it can give a good training; and 
I don*t think that, even if it has less than 
twenty-five beds, with that equipment it should 
not be admitted, and yet there is no provision 
for any such in the statement. It says: *'Hos- 
pitals with less than twenty-five beds unless 
they can affiliate." Now, that isn't absolutely 
true of all small hospitals; it doesn't need to 
be true, and therefore I wish to take excep- 
tion. I am sorry to have to be a little per- 
sonal in it, but I know — because we have 
proved it in our little hospital, because wc 
have had four graduate nurses there as super- 
intendent of nurses, assistant superintendent, 
head nurse and as night head nurse, all gradu- 
ates of a large hospital where they had fine 
training. And Dr. Richard Cabot made a point 
that it should be not the number of beds, but 
the number of cases, and by that classification 
our little hospital made an excellent showing. 
Taking the number of patients to the nurse it 
made a much better showing than some of the 
large hospitals which were by this report al- 
lowed to handle training schools because they 
had a larger number of beds, but in a classifi- 
cation that gave the number of patients in 
those hospitals they didn't have as many pa- 
tients per nurse as we had in our little hos- 
pital. 

Then this small hospital must have its nurs- 
ing done by graduate nurses. They can't af- 
ford it any more than the large hospitals; and 
will you show me the large hospitals that 
could afford to go out and hire all its nursing 
done by graduates? We have had occasion 
in the last few months to look up a superin- 
tendent, and one of those who was under con- 
sideration was one who had been superinten- 
dent of three different hospitals, and one of 
them was where they had all graduate nurses, 
and she says, "I don't want anything more to 
do with the general hospital with all graduate 
nurses; they are too independent! You can't 
make a graduate nurse do the things as you 
want them done, and you can't maintain the 



same discipline!" Now, what is this small 
hospital going to do with those graduate 
nurses? 

Another thing. You say send these nurses 
around to special hospitals. We have had a 
little experience in that. We had an arrange- 
ment with one of the first hospitals to take up 
obstetric training, to send our nurses to 
another hospital for obstetric training, and we 
have been crowded out by large hospitals that 
have waked up to the fact that it is necessary. 
We were crowded out by two large hospitals, 
and the hospital to which we had sent our 
nurses felt that they would rather have nurses 
from two large hospitals than from several 
small ones. I was told that by one of the 
physicians. They said, "Your nurses are first 
rate, they are well trained, but we have to take 
them from so many different hospitals that 
we rather have them from two large hospitals 
— which we can do!" 

While our nurses were there they were 
found to be competent and well trained in the 
Caesarian section, and at one of the hospitals 
they were told that their nurses must have 
better training along that line before they 
came there. To-day we have got up where 
wc have our twenty-five beds, so we are al- 
lowed to have a training school. 

Our superintendent, who has been there 
twenty-five years, was opposed — didn't believe 
ni training schools — and she accepted it 
under protest, because it was the only way wc 
could get our patients cared for. She is to- 
day a very enthusiastic advocate and believer 
in the small training school, and thinks it can 
do some things that the large training school 
cannot. And I think we ought to recognize 
the fact that both have their advantages, and 
I agree most heartily with the report except 
that statement that the hospital of less than 
twenty-five beds should not maintain a train- 
ing school. In obstetrics— we have had thirty- 
four maternity cases this year, and our nurses 
are under the superintendent's control, and in 
some larger training schools they are not 
learning what our nurses are. And our nurses 
who come in contact with nurses from other 
hospitals come back somewhat demoralized; 
for instance, in the matter of bedclothes. We 
have had trouble lately — ^within the last twelve 
or eighteen months — and nurses come back 
saying, "You can't help having trouble, of 



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264 



THE TRAINED NURSE AND HOSPITAL REVIEW 



course you will have bed troubles sometimes." 
And sometimes when they have come back the 
bedclothes were a disgrace, but we are getting 
them back to the standard again. Our own ex- 
perience is that it is a question whether you 
want to let your nurses go, unless you know 
where they are going. 

And we are fortunate enough — and I speak 
of our own training school, because I want to 
stand for the idea — we are fortunate enough 
to have got as the next superintendent one 
who has had a fine experience, and our hos- 
pital will still have graduate nurses for its 
superintendent of nurses, its assistant super- 
intendent and its head nurse, all from one of 
the largest training schools in Massachusetts. 
Now I believe that you are entitled to have a 
training school, even if you haven't twenty-five 
beds to begin with, and in this way you can 
give your nurses good training. We have four 
of them nursing in New York City, doing 
good work; we have two doing district work; 
we have one that has been in the infants' hos- 
pital in Boston and was offered the position of 
assistant superintendent there, all from that 
little school. 

Excuse me for being so personal, but I 
wanted to say something for the small school. 

Adjourned at 9:55. 

+ 
Connecticut. 

The first meeting of the season of the 
Alumnae Association of the Connecticut 
Training School was held Thursday, Septem- 
ber I at the hospital dormitory. In the ab- 
sence of the President, Miss Margaret Stack, 
and both vice-presidents, Mrs. Burwell called 
the meeting to order. After the general routine 
a discussion, of ways and means for the fair 
to be held this Fall, some time in November, 
was had. Some of the committees w^ere ap- 
pointed to start the work, and at another meet- 
ing, held Friday, September 9, at 3 p. m., all 
graduates in the city from all schools were 
invited to meet at Mrs. J. Marsh's home, No. 
858 Howard avenue, to perfect the plans al- 
ready started. We hope our friends out of 
town will be prompt in sending in their con- 
tributions of useful and fancy articles. We 
would be most grateful for dolls from any 
school dressed either as orderlies, doctors or 
in the uniform the nurses wear. Mrs. J. 
Marsh will take care of all contributions sent 



to her, as she has ample room to store any- 
thing from a pin cushion to an automobile. 
Sixteen nurses met with Mrs. Marsh to seiw 
rags for rugs for the rug booth on Friday, 
August 26, at 6 o'clock. Mrs. Marsh served a 
delicious supper. Mrs. Brown told fortunes, 
the proceeds are to be added to the delegates' 
fund. 

Be sure and send in your order early for 
one of those lovely washable rugs, for the 
weaving of which we are indebted to Mrs. 
Marsh. 

+ 

New York City. 

The regular monthly meeting of the Alum- 
nae Association of the N. Y. C. T. S. was 
held at the Academy of Medicine, No. 17 West 
Forty- third street, Tuesday, September 13, at 
3 p. m. There was a lecture by Dr. William 
L. Stowell on infant mortality, and afternoon 
tea was served in the banquet hall. 

+ 
New York. 

At the annual meeting of the Buffalo 
Nurses' Association the following officers 
were elected : President, Mrs. Harriet D. 
Storch; first vice-president, Mrs. Gertrude W. 
Boyd; second vice-president. Miss Mary 
Jayne Cole; corresponding secretary. Miss 
Allie Lindsay; treasurer. Miss Nellie Davis; 
recording secretary, Mrs. Florence Lehr; City 
Federation secretary, Mrs. J. L. Brodie; West- 
ern Federation secretary, Miss Maud B. Crary ; 
trustee, Mrs. Jennie Anderson; directors. Miss 
K. I. Kennedy, Miss Margaret Kennedy, Miss 
Margaret Kanierer, Mrs. A. J. Martin. 

+ 
Pennsylvaniia. 

The Pennsylvania State Board of Examiners 
for Registration of Nurses is sending out the 
following statements for publication: 

"In reviewing the work of the past year the 
board feels gratified at the general interest 
taken in the work, not only among the gradu- 
ate nurses, but also physicians and the public. 
The number of graduates registering far ex- 
ceeds the expectations of the board and regis- 
tration in other States. The board is happy 
in the thought that the standard of the hos- 
pitals graduating nurses in this State is of a 
very high order of efficiency, and that the 



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When you write Advertisers, please mention The Trained Nurse. 



266 



THE TRAINED NURSE AND HOSPITAL REVIEW 



management of these hospitals is making every 
effort to establish a uniform curriculum, and 
training their pupils in a reasonable and prac- 
ticable way. 

"The board recognizes the fact that time 
will be necessary for a certain proportion of 
the training schools to come to that standard 
which the medical profession throughout the 
State requires, and the fact should be empha- 
sized that this board is most anxious to be of 
assistance to those schools so that when exam- 
inations begin the entire medical and nursing 
professions will be satisfied with the registra- 
tion law as administered by its board. 

"For the good of registration in Pennsyl- 
vania each member of the board has taken a 
personal interest in nursing affairs in all its 
aspects. They have been untiring in their ef- 
forts to place the subject properly before the 
public. It now remains for each individual 
graduate, who has registered, to show to the 
public and medical profession that registration 
is a guarantee that she is obedient to the doc- 
tor's orders, that she has skill in carrying out 
those orders in a way that will produce the 
results expected by the medical attendant, and 
with the least possible expense and discomfc.rt 
to the patient. 

"The registered nurse should study in a 
practical way all those points taught her in 
her training days, regarding patience, loyalty 
and obedience, and practice them as a nurse 
under the direction of the physician. She 
should refrain at all times from criticising the 
medical management of any case. In emergen- 
cies she should consider herself a layman with 
some ability to keep the patient safe until 
proper medical attention arrives. 

"It is the opinion of the board that those 
nurses having the best training are those that 
appreciate the value of registration and arc 
most cautious in assuming responsibility, and 
that it is the poorly trained and ignorant 
nurses who very foolishly call upon their 
profession the odium which their actions war- 
rant. It might be well for all registered nurses 
to commit to memory a quotation from an 
editorial in the 'Pennsylvania Medical Journal' 
of May, 1910, which is as follows: 

"The title "Registered Nurse" will be of 
value just in proportion as experience shall 
convince physicians that nurses that have 
passed the State Board are, as a rule, better 



than nurses that have not passed such an ex- 



» f» 



ammation. 

On page 182 of our September number we 
published a picture of a group of nurses with 
their superintendent. By a printer's error it 
was stated that these nurses were from New 
York, whereas they were from the Conc- 
maugh Valley Memorial Hospital, Johnstown. 
Pa. The superintendent in the picture is Miss 
Jessie L. Greene, and in this connection it is 
interesting to note that Miss Greene has l)een 
connected with the hospital sixteen years, hav- 
ing graduated in the first class after the train- 
ing school was started. She has been superin- 
tendent of the hospital and traini?ig school for 
ten years. The class is the twelfth class 
graduated from the school. 



Camp Liberty Bell, Spanish-American War 
Nurses, entertained at luncheon Tuesday, Sep- 
tember 20, at the headquarters. No. 922 Spruce 
street, Philadelphia, Pa., the visiting delegates 
to the convention at Atlantic City. 



The regular monthly meeting of the Nurses' 
Alumnae Association of thfe Mcdico-Chirurgi- 
cal Hospital, of Philadelphia, Pa., met at the 
hospital, September 7, at 3 p. m. 

The attendance was fairly good, this being 
the first meeting after vacations. It was de- 
cided to hold a dance this Fall for the pur- 
pose of raising money for our endowed room. 
Much interest was manifested and we expect 
every meml)er to assist the committee in 
charge. 

After the regular business of the meeting a 

short social hour was enjoyed. 

+ 
Oklahoma. 

The graduate nurses of the State of Okla- 
homa will hold their second annual convention 
in Muskogee, October 18 and 19. The meet- 
ing will be held in Commercial Club Audi- 
torium. Many pleasures have been planned 
by the local association for the visiting nurses, 
and it is hoped that all who attend the meet- 
ing will receive much benefit. 

+ 
Married. 

Miss Martha Waugh, of Waterbury, Conn., 
was married July 20 to Mr. George Fawley, of 
Argyle, N. Y., where Mr. and Mrs. Fawley 
will make their future home. 



ADVERTISEMENTS 



AwlL\%eTmo\m^ 



Relieves 
Local 
Pain and 
Inflammation 

(Apply Externdly) 

TRIAL 
PACKAGE 
ON 
REQUEST 



NOW SUPPLIED IN GLASS JARS 
Retail Prices 



a W. CARNRICK CO. 

2 SULLIVAN ST., N» 

When yoTi write Advertlsara, pJense mention Thb Tkaimid Nunea. 



SOI. GlassJar»-$ .25 I ijf lb. Glass Jars-|i.( 

" - sols " " "- 2.25 42 SULLIVAN ST., N»w YoA City 



268 



THE TRAINED NURSE AND HOSPITAL REVIEW 



At Providence, R. I., August 31, by the Rt. 
Rev. Mgr. Doran, Miss Amy Mary Bissett to 
John Thomas Collins. Mrs. Collins is a grad- 
uate of St. Joseph's Hospital, Yonkers, New 
York, class of 1900. Mr. and Mrs. Collins 
will reside at Newport, R. I. 



Miss Mary Kennedy, of Battle Creek, Mich., 
was married August 17 to Mr. Rufus F. Katz, 
of Marshal, Mich. Mrs. Katz is a graduate 
of Kalamazoo Hospital Training School, class 
of 1905, and has been a very successful pri- 
vate nurse for the past five years. Mr. and 
Mrs. Katz will reside at Marshall. 



The marriage is announced of Miss A. J. 
Haentsche, formerly of the Division Hospital, 
Manila, P. I., to Mr. P. Hube. 



Miss Effie J. White, a graduate registered 
nurse of the Homeopathic Hospital Training 
School of Iowa City, la., has recently quit 
the nursing profession and taken up the duties 
of housekeeper. On July 12 Miss White was 
united in marriage to Mr. Ernest A. Opitz 
by the Rev. Mr. Locke at the Methodist par- 
sonage, Tipton. Mr. and Mrs. Opitz will re- 
side on the farm owned by Mr. Opitz, about 
seven miles from Tipton. Mrs. Opitz located 
at Tipton about seven and a half years ago 
and has been very successful in her chosen 
profession. She has many friends who join 
in wishing her and her husband much joy in 
their new life. 

+ 
Personal. 

Miss (Emma C. Forbes and Miss Edna 
Howe, graduate nurses of the New London 
Memorial Hospital, Conn., have been taking 
a trip through the Yellowstone Park. Both 
nurses have been graduated some years, and 
this trip is a well earned rest from work. 



Miss Mary Louise Cfosby, graduate nurse 
of the Shenango Valley Hospital, New Castle, 
Pa., succeeds Miss Bessie Bassin as superin- 
tendent of Wilson Hospital, Mayville Ky. 



Miss Margaret Frances Donahoe, chief 
nurse of the Philadelphia Hospital, Philadel- 
phia, Pa., has resigned her position and Miss 
Nellie May Rennyson, who has been Miss 
Donahoe's assistant for some years, has been 



appointed to fill her place. The vacancy 
caused by Miss Renny son's promotion will be 
filled by Miss Margaret Kelley, a graduate of 
the school. Miss Kelley was the gold medalist 
of her class. 



The following students of the Pennsylvania 
Orthopaedic Institute, Philadelphia, Pa., re- 
ceived their diplomas at the end of the Spring 
term: Hallie C. Cord, Ruth Bennett, Annie 
F. Tidy, Margaret Foresman, Kathrine Steven- 
son, Clara B. Beauford, Anna M. Gutbrod, 
Madge Rafferty, Amanda C. Small, A. Frank 
Funk, Mabel F. Graj', Nellie S. Byram. 

Resolutions. 
Miss Bertha Winkler, a graduate of the 
Lutheran Hospital Training School, St. Louis, 
of the class 1909, died September 3, of 
typhoid fever after an illness of three weeks. 
Whereas, It has been the will of our 
Heavenly Father to take to Himself one who 
was greatly loved by friends and those to 
whom she ministered in her profession. 

Resolved, That we, the members of this 
Association, realizing this great loss, extend 
our deepest sympathy to her bereaved ones, 

Resolved, That a copy of these be sent to 
her family, to the Trained Nurse and to the 
Association. 

Cordelia Ranz, 
Kate Kottkamp, 
Adele Kieckers, 

Committee. 
+ 

Obituary. 

Died — At Innisfree, Alberta, Canada, Aug. 
31, Ralph, eldest son of Mr. and Mrs. J. J. 
Gulley. Mr. Gulley was engaged on his farm 
loading his wagon with wheat, his little son, 
in his ninth year, was holding the horses, when 
he dropped one of the lines, and in reaching 
for it lost his balance and fell on the pole be- 
tween the steeds. The horses started to run, 
dragging the vehicle over the abdomen of the 
child, causing such serious injuries that he 
died a few hours later in spite of all the 
physician and his mother (a skilful nurse) 
could do. Mrs. J. J. Gulley was formerly 
Miss M. E. Reilly, a graduate of St, Luke's 
Hospital, Newburg, N. Y. 



ADVERTISEMENTS 



PEAK'S SUPPORT fOR AFTER OPBUTION 

fir 



Wben you write Adve 



IMl He 

Price, $!.?» 



HiUl DEIMEL ABDOMINAl BQTS 

t doicng at otiicra described id Calaloiue dI Belli 

Elastic Stocliings, Ankieb, 
Knee bps, Tnjsses, etc. 



TheMaxWocher&SonCo. 

bifilil fmmn. Ima' Cixt. tic 

i»^z] wtd sti Sbtti. • cmanAii 



s mention I'ue Tbaimbd Nubsb. 



^etD Hemetrted ant> ^Imnmt 



"A Grand Thing." 

"I have used Unguentine in cut fingers, 
burns and bruises and found it to be a 
grand thing." D. L. Ross. 

Scotland, Conn. 

+ 
Constipation. 

Among the countless remedies that have 
been used for overcoming constipation, none 
have been found to possess qualifications so 
completely as Prunoids. 

+ 
Reliable Lieterine. 

The vapor evolved from Listerine in the 
sick room, by a spray, or saturated cloths 
hung about, is actively azonifying and im- 
parts to the atmosphere an agreeable odor, 
which proves very refreshing to the patient. 

+ 
Bodily and Mental Strain. 

The great "bodily *ind mental strain to 
which a trained nurse is subjected, the loss 
of health and nerve power, through loss of 
sleep, irregular meals and hard work, is best 
met by using Horsford's Acid Phosphate. 
Try it and see. 

+ 
An Unexcelled Combination. 

Two parts of dioviburnia to ane part of 
neurosine is par excellence in hysteria, 
eslampsia, melancholia, female neurosis, 
uterine congestion, ovarian neuralgias, re- 
lieves all false pains, rheumatic, sciatic pains, 
neurasthenia from uterine diseases. 

+ 
To Relieve the Effect of Solar Heat. 

Direct exposure to the sun's rays; employ- 
ment in or living in hot and poorly ventilated 
offices, workshops or rooms, are among the 
most prolific causes of headache in Summer 
time, as well as of heat exhaustion and sun- 
stroke. For the pain following sun or heat- 
.stroke, antikamnia in doses of one or two 
tablets every two or three hours will produce 
the ease and rest necessary to complete re- 
covery. 



Even from Spain. 

It is contrary to my custom to write testi- 
monials, but the results I have obtained from 
the use of Resinol Ointment and Soap are 
so extraordinarily satisfactory, that I think 
it my duty to say a good word for these 
products. 

Dr. Eduardo Toledo y Toledo. 
Madrid, Spain. 

+ 
Ergoapiiol (Smith). 
The invigorating action of Ergoapiol 
(Smith) on the uterus and its appendages ren- 
ders it of extraordinary service in cases of 
suppressed or scanty menstrual flow. The 
stimulating action of the preparation on the 
sexual apparatus is excetionally marked and 
prompt, and its employment is invariably ad- 
vantages. 

+ 
Prompt and Satisfactory. 

Jacksonville, 111., Jan. lo, 1910. 
Ogden & Shimer, Middlctown, N. Y. 

Dear Sirs — I send again for your fine Mys- 
tic Cream. This time I am going to order 
two jars, as I can not find anything as satis- 
factory as Mystic Cream. Thanking you for 
sending it so promptly always, I remain, 
Yours truly, Miss L. L. Depew, T. N. 

+ 
After Appendectomy Operations. 
Peak's Support, while not a particular new 
device, nevertheless, has been recently highly 
recommended for supporting the incision af- 
ter appendectomy operations. Many hospitals 
have been using it on their patients very suc- 
cessfully for some time. It is made by the 
well-known Cincinnati firm, The Max Wocher 
& Son Company. 

+ 
A Gallstone Operation with H-M-C. 
I have recently used H-M-C tablets (Ab- 
bott) for gallstones on a patient of sixty- 
seven years, whose condition did not war- 
rant a general anesthetic. The use of H-M-C 
tablets was supported by the local use of 



ADVERTISEMENTS 



INSTRUCTION IN MASSAGB 

THE SYSTEM YOU WILL EVENTUALLY LEARN 

Swedish Movements* Medical and Orthopaedic Gymnastics 

T«nni 5 Montha Taition F—. S75.00 

Course In Electro*Therapy 

T^rmi 2 Months Tuition Foo» $25.00 

Course In Hydro-Therapy In all Its Forms 

Tormi 6 Wooko . . • . Tultton Foo* $30.00 

SECOND SECTION OF FALL CLASSES OPENS NOVEMBER 17fli, 1910 

Winter ClasAas Open January 10th and March 21st, 1911 

OVER 9000 TREATMENTS GIVEN IN 1909 
Mo mmttmr OUntomi mxporimnom ^looolb/o 

All cottnct nay be cominciiced at tha ■aiut time sad fialihed withia three inontlw. 

The initmctioB coniUte of daily clinical work and practical leieona on patients referred to our elinica iron 
the Tarioaa Hoepital Dttpensariea. Orifinal Swedish (Ling) ayiteni, and weir Mitchell's Res^Care system. 
AU pupils attend clinics at sereral city hospitals. Separate male and female classes. Payments can be made 
to snit your conTcnience. Partievlars and illustrated booklet on Massace upon request Aa early 
applkaUea feradailiilaa Is advisahle. 

INSTRUCTORS 



Wm.Eoiht RoBiETioif.M.D. (Professor of Medi- 
cine. Temple University). 

Eldridgb L.Eliasgii.M.D. J •» Pennsylvania). 

Louis H. A. von Cotzhaussm, Ph. G.. M. D. 
(Graduate Phila. College of Pharmacy. \ied. Dept. 
University of Penna..Penna. Orthopedic Institute). 

Wm. EawiM. M.D. (Hahnemann and Rush Med. Col.) 



Max J. Waltbb (Univ. of Peana., Royal Univ.. 
Breuau. (xermany. and lecturer to St. Joseph's. 
St. Mary's. Philadelphia General Hospital (Block- 
ley). Mount Sinai and W. Phila. Hasp, for Women. 
Cooper Hoap.. etc.) 

HtLBMB BoNSDomrv(Gym. Ins..StockliolmtSweden). 

LiLLii H. Mamshall UPennsylvaaia Orthopadie 

Editb W. Knight } Institute). 

MAaoARBT A. Zabbl ((xerman Hospital. Philadel- 
phia. Penna. Orthopaedic Institute). 



Pennsylvania Orthopaedic Institute and School of 

Mechano-Therapy (iaaagp«rata4) 

1711 GreM Street, rillLADELFHIA, PA. MAX J. WALTER, SiperMcudeflt 



JOPeBorax lodine^Bran "Afr 

ACT5 LIKE MAGIC 

40 Years the StancUtrd of EffJcienqre 

Instantly Stops that everlasting Smarting, Aching and Foot 
Weariness. Dissolves Corns and Callouses. Soothes and re- 
moves Bunions and all Inflammations. Relieves and Prevents 
Excessive Perspiration. A triumph of medical skill. Worked 
out by William Johnson, graduate of the Lxjndon Chemical 
Laboratory. One cake will demonstrate it. Buy a cake to- 
day and know what Foot Comfort means. 

Large cake, 25c, All druggists. Samples free on request. 

Money Back if Not Satisfied. 



WILBUR A. WELCH. Sole Dislributor. 



905N Ratiron Building. New York 



When you write Advertisers, please mention The Trained Nurse. 



272 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Schleich's mixture, and the operation was 
completed, including the removal of over 700 
gall stones without any pain to the patient 
and no subsequent nausea. (I also find this 
preparation the pest pain reliever I have ever 
used. C. H. Bush NELL, M.D. 

+ 
A Convenient and Stable Solution. 

A solution of Boric Acid is always con- 
venient to have at hand. To make the solu- 
tion add one heaping teaspoonful of Boric 
Acid to a quart of warm water. The solu- 
tion should be shaken occasionally until the 
Boric Acid is dissolved,. When once dis- 
solved it will keep in this condition indefi- 
nitely. 

+ 
In Exhauetlon. 

In all conditions of mental and physical 
exhaustion accompanied by malnutrition .its 
effects are speedily manifested by an increase 
in functional vigor and a general improve- 
ment in the health of the whole body. Phy- 
sicians who are not using Gray's Glycerine 
Tonic Comp. in their cases of general de- 
bility are urged to do so and note what 
really remarkable results they can obtain. 

+ 
School of Massage. 

The fall class of Schoool of Medical Gym- 
nastics and Massage opened September 6, and 
will continue until December 6. The first 
weeks are devoted to demonstrations and 
practice in the technique of massage. New 
students from out-of-town are always assisted 
in finding suitable, inexpensive boarding 
houses in the vicinity of the school. 

+ 
Formaldehyde DIelnfeotlne Compound. 

U. S. Disinfectine Compound is manufac- 
tured in the laboratories of the United States 
Chemical Company, under the direct super- 
vision of Dr. Carl L. and Thornton B. Barnes. 
Extensive bacteriological tests prove that one 
box of U. S. Disinfectine Compound, in 
combination with one pint of water, will 
thoroughly disinfect a room of 1,000 cubic 
feet capacity. It is the best disinfectant to 
use in smallpox, scarlet fever, diphtheria, 
tubercolosis, measles, anthrax, typhoid fever, 
etc. Simple! Safe! Secure! U. S. Disin- 
fectine Compound, the new disinfectant, will 
not stain or injure the finest fabrics. 



Send for Circular. 

The hospital devices illustrated in our cir- 
cular, and one of which is seen in our ad- 
vertisement in this issue, are the result of a 
deep insight into the needs of hospitals, and 
much thought and inqenuity to supply those 
needs. Our registers are exceedingly practi- 
cal, simple in system, strong, of exceedingly 
good material and workmanship. 

The Universal Register Co. 

+ 
Chocolate Icing. 

Make a vanilla icing, and add one table- 
spoonful of cold water to it. Scrape fine 
one ounce of Walter Baker & Co.'s Premium 
No. I Chocolate, and put it in a small iron or 
granite-ware saucepan, with two tablespoon- 
fuls of confectioners* sugar and one table- 
spoonful of hot water. Stir over a hot fire 
until smooth and glossy, then add another 
tablespoonful of hot water. Stir the dis- 
solved chocolate into the vanilla icing. 

+ 
What It Is and Does. 

The Acousticon is an electrically operated 
instrument, constructed in exact accordance 
with nature's laws, as to the transmission, 
multiplying and clarifying of sound-waves. 

With it those who are deaf or hard of 
hearing can be supplied with the exact degree 
of accentuated sound that they require, and 
thus artificially equipped with what Nature 
denies them are placed on a plane of practi- 
cal equality, so far as normal hearing is con- 
cerned, with all their fellow men and women. 

+ 
Description of Relay. 

The Sturm Signal System Relay, for hospi- 
tals, is mounted on a slate base in a pressed 
steel box, black enamel finish, 6 inches wide, 
6y2 inches high and 4 inches deep. The box 
contains all necessary fuses, binding posts 
and pilot lamp socket. The size of the box 
remains the same irrespective of the number 
of signal lights. 

There is nothing to get out of order, as Ihe 
relay signal box contains but one movable 
part, which is operated by electricity and re- 
stored by gravity. 

The entire operating expense consists of 
the electric current which is uspd only during 
the period when calls remain unanswered. 
Inasmuch as all signal and pilot lights are of 



ADVERTISEMENTS 



Philadelphia Orthopaedic 

Hospital and Inflnaary 

for Nervous Diseases 



TIk PHILADELPHIA <»1HO- 
PAEDIC HOSPITAL AND INFIRM- 
ARY FOR NERVOUS DISEASES, b 
«4ucli iutnicIMm m mmm««, corracliv* wd 
TC-wluealiMMl ijmaulic* liu been girea for 
tflBM jr«an, now prapa*a to extend and 
•nUrge Am *capt of im lf»ching. and aS«n 
« cdune in dioe nibjecb irikkli it n bcliered, 
wilk di« snnt vaiieljt mk! quuilitj <^ vaM- 
rUI for altenatiaa and pnclic* >l ibe cG*- 
poad of As ho^ilal, cmnol be eqnaUd w 
(hit CBuntr]'. 

Dnriea Am tut 1906 iIm numitar of 
pTeo i> lb* oul-patieni departBeal 
h tfac Qunaage aad Bwdtcel-axerciM 
oicoeded len moiuuid. Beaide* liiH 
■dvanced popili ban opportunitict of pvkf 
eeacral uhI ipecUl niewagB la patieali a dia 
hoipilal ndar wy ar ki ag of ibe ioabnclon m 



Ilka •id>iacl* conrad hf iu c 



•f general diiraira of nutrition, nanraitlicnia, 
bjnteiia, cborea, clc^ and hj nuxaga ud cx- 
crciK in cenfcra] nod ipiaal pamlpii, infan- 
t3e pal^, tnsmMic iuHiia* <if Am •pBud cord, 
taliona. joint wfiiciioD*. ^Eunlilici fol- 
af fraelurcf, bami, ican, etc; tpjnal 
cnrratura and alber poelnral jefomitica, lal 
foot, di^ foot, contracturci and iba kandHng 
of locomotor ataxia b7 precitioa and co-ar<i- 



Tbe 



win I 



_ nth*, beginnbii in Oclobei, 1909. Lecluiei 
win be pven by Dr. J. K. Mitchell, Dr. Wn. 
J. Taylor, Dr. C C. Davit, Dr. Frank D. 
DicboB and Dr. Wn. J. Drayton, Jr., urbila 
tha practiGal leacbini occnpie* from ibree to 
four houn daily. 



Ilaea deiiroQl of entering du claN. «rluch 
will be Wited b number, ibonld api:4; to the 
■uperintCBdcnl of die hoipital, wbo will tend 
a circular wilb detail* of die requiremente for 
admiMiaa. Tbe fee for Am courM ■• $100. 

A iborter couna of initmcbon in tha thera- 
peutic naei of Electricity, aiilable for pupih, 
may be taken with the mechano-tbcrapr or 

Thi> couiaa lait (onr man^ and iha fee 
ii 125. 



1701 Summer St., Phila., Pa. 



When you write AflvertlHert, 



One of above special bottles of 
Q/ycO'J hymoline will be sent 

FREE 
Express Prepaid 

to any Irained Nurse on appli- 
cation. 

We want you to know the value 
of Qlyco-Thymoiine. It stands 
on its merits. 

Mention this Magaiine. 

fCRESS & OWEN COMPANY 

310 Fulton St., New York. 

ploaae mention Tm Ta^iNnD Nuasn. 



274 



THE TRAINED NURSE AND HOSPITAL REVIEW 



eight candle power, this operating expense 
is exceedingly small. No motor generators, 
rectifiers, transformers or storage batteries 
are necessary with this system. 

+ 
Only the Oil Omitted. 

Clinical experience with Hagee's Cordial of 
the Extract of Cod Liver Oil Compound 
justifies the asserttion that its therapeutic in- 
dications are precisely those which belong to 
cod liver oil in its natural condition. 

The fatty element (and this alone) is in- 
deed completely eliminated, and while the 
nutritional value of that factor is undoubted, 
it must not be forgotten that oil will not be 
tolerated in many of the cases for which 
cod liver oil is indicated. 

+ 
Qastro-Jejunoetomy. 

After gastro-jejuncstomy, or partial gas- 
trectomy for cancer, Patcrson feeds the pa- 
tients up rapidly, allowing mutton or beef 
essence, jelly, eggs and Benger's Food on the 
second day, and often fish or chicken cream 
on the third day. Patients who have been 
exhausted by weeks or months of vomiting 
will not stand starvation, and their tissues 
possess feeble power of repair unless they 
are provided with plenty of nourishing food. 
— The Practioner, London, March, 19 lo. 

+ 
Palatable, Pleasing, PostumI 

Coffee should never be given to children 
any more than tobacco. It contains an alka- 
loid which tends to interfere with the proper 
development of the child's nervous system. 
This alkaloid is caffeine, well known as af- 
fecting the nervous and circulatory systems. 
Children should be given some harmless 
beverage instead of coffee or tea — say, Pos- 
tum, which is made of clean, hard wheat, in- 
cluding the bran-coat containing the valuable 
phosphates so necessary in elaboration of 
nerve-cells. 

+ 
Compotitlon. 

In Horlick's Malted Milk, the food value of 
pure cow's milk is made available with the 
nourishment of choice malted grain in a 
permanent powder form. In the final pro- 
cess of manufacture the casein of the milk 
is modified so that it becomes soluble and 
very easily digested. This unique combina- 



tion of the solids of milk with the phos- 
phates, the carbohydrates and other nutritive 
principles of the cereals makes a complete 
food where milk is indicated as- the chief 
diet. 

+ 

Watoh it Work. 

So many physicians misunderstand Pneumo- 

Phthysine, taking for granted that it is one 
of the numerous preparations gotten up as a 
convenient "placebo," but the nurse, whose 
business it is to watch, with the eye of an 
eagle, for the minutest symptoms arising fro n 
both the disease as well as remedies given to 
influence the course of the disease, will usually 
be the first to find that Pneumo-Phthysine so 
radically influences the course of the disease 
conditions for which it has been prescribed 
that it soon becomes the mainstay in positive 
therapeutics. 

+ 
Summer Diarrhea In Infants. 

Summer diarrhea is almost invariably the 
result of improper feeding. The fact that 
infants fed on Nestle's Food seldom suffer 
from diarrheal disorders is most significant. 

It shows conclusively that this well bal- 
anced nutrient, derived from the purest of 
cows milk and carefully selected cereals is 
not only digested and absorbed with no un- 
due tax on the digestive organs, but that 
bacterial contamination is so avoided that 
fermentative and putrefactive changes are 
practically unknown. 

+ 
New, Necessary, Progressive! 

The Holtzer-Cabot Electric Company, of 
Boston and. Chicago, have recently equipped 
a number of large hospitals with their silent 
signaling system. They are also manufac- 
turing at the present time systems for sev- 
eral large hospitals now being constructed. 
The company is prepared to furnish systems 
of several different patterns to suit condi- 
tions, and would be glad at any time to take 
up the matter of hospital signaling apparatus 
with anyone who is interested. The com- 
pany has recently brought out several new 
articles in connection with this class of ser- 
vice which are novel and which cover some 
of the points that have not been properly 
taken care of heretofore in this class of 
work. 



ADVERTISEMENTS 



20 Mule Team Products 

For the Kurssry and Sick-BooM 



BORAX is one o£ the mildest antiseptics 
known; in fact it is comparatively the 
only one known that is wholly safe to use 
in the sick room. Tlierefore, it can be used 
in the place of more powerful antiseptics, 
which are frequently the cause of poisoning 
a patient. 

Borax can be used indiscriminately in the 
sick room for softening water with which to 
bathe the patient, and for thoroughly cleans- 
ing' bed linen, soiled garments and utensils. 

A boric acid solution is cooling and soothing 
for the eyes, for inflamed cuticle or the mu- 
cous membrane. Boric acid spangles are the 
best to use for making a solution. Boric acid 
in a powdered form is unsurpassed as 9 dust- 
ing powder. 

20 Mule Temm Bor&z. Borlo Add *nd Span- 
Sles a.ro All vaokiai lo convenlBDt carton* for 
tha nurse to bandla. The SO Uule Team 
Brand is alwan a KU*ranlee of purity. 

Writs for our "Magic Oryttaf iooktet — free 



PACIFIC COAST BORAX CO. 

N«w Yoric : : Chicago i : 0>kUnc 



"Well, Well! 

I bear yoa perhcdy DOW 1 " 

I OBIAJI yai MTBhwi t> 
1 Uie nom; wtu, 1 cddU 



1 m hM 



flcd doulf, uid 

TRY IT AT OUR EXPENSE" 

ulUfuurtly Uie Ulil will ooU jou iHtlif^. No trial 
fe«( Bs Denalt*, It jam do not kear. 

A w nctat ud DimoUcMUv heid-lMiid I* tonliliM 
witb Ois tir-idgoa: Ita oh maka II muuccHUT to balil 
U« •"■P»«e md Win boUi hand) pRfectL; fm 

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The General Acoustic Co. 

St>5 BcownlnE Bnlt^i. Bmdwi; uid 32Dd St 
NXW YORK. 



tU&a la afTideiFt iiDdR- 
Write (or pvUcuian i 



276 



THE TRAiNEb NURSE AND HOSPITAL REVIEW 



Seeing Is Believing. 

Under the Three R trade mark there is 
published a a series of helps for nurses that is 
creating a very favorable impression among 
professional circles. 

First of these helps is an ingenious combi- 
nation of all the thermometers that the 
nurse will ordinarily use. Taken in connec- 
tion with the R. R. R. method of replacing 
broken thermometers, this is no doubt the 
most economical as well as convenient article 
of professional equipment that has appeared in 
recent years. 

+ 
Are You In Needf 

If you are in need of any kind of nurses' 

supplies, sick room utensils, invalid requisites, 
send for the very full and complete catalogue 
published by the Valzahn Company, 1629 
Chestnut street, Philadelphia, Pa. In this 
catalogue you will find simply everything 
from a twenty-five-cent grooved director to a 
maternity packet (by the way, it is worth get- 
ting the catalogue simply to see these). Noth- 
ing is overlooked. Nurses' bags and chate- 
laines, thermometers, hypodermics and uten- 
sils of every kind are illustrated and priced. 

+ 
Dole's Pineapple Juice. 

Have you tried it? It is the pure non- 
alcoholic juice of ripe pineapples bottled 
where grown — a wonderful new drink, very 
refreshing and satisfying. 

Take one pint pineapple juice, three parts 
water, sugar to taste, and crushed ice, give 
this to your patient for a change. Recom- 
mended by a very prominent doctor as espe- 
cially useful in diseases of the throat and 
intestinal tract. 

Ask for it at your drug store or grocery 
store. If you cannot get it, write The 
Hawaiian Pineapple Products Company, 112 
Market street, San Francisco, California. 

+ 
The Ill-Nurtured Baby. 

The first thing to be investigated is the 
character of the child's food, the frequency 
of feeding, etc. In addition to this, however, 
the little patient often requires some "fillip" 
to vitality, a mild general tonic and recon- 
structive. For this purpose nothing is more 
generally beneficial than Pepto-Mangan 
(Gude), in doses proportionate to age. Be- 



ing palatable, even young children take it 
readily. As it is free from irritant proper- 
ties, it is readily tolerable and absorbable, 
without disturbing the digestion or producing 
constipation. 

+ 

In 1888 

The London Lancet, after a careful examina- 
tion of Scott's Emulsion, reported that "the 
preparation fulfills all the requirements and pre- 
sents all the conditions of a very satisfactory 
emulsion. In appearance and consistency it is 
not unlike cream and under the microscope the 
fat globules are seen to be of perfectly regular 
size and uniformly distributed. So well has 
the oil been emulsified that even when shaken 
with water the fat is slow to separate. The 
taste is decidedly unobectionable and the 
emulsion should prove an excellent food as 
well as a tonic." 

+ 

Prepared Barley. 

Use Robinson's Prepared Barley for making 
gruel. It is perfectly delicious, made with 
milk and acceptable to the most fastidious 
patient. 

Barley water is very useful in quenching 
thirst of fever patients, and no barley is so 
thoroughly satisfactory as Robinson's. For 
sale at both drug and grocery stores. Send 
to James P. Smith & Co., 90 Hudson street, 
New York City, for an illustrated booklet, 
giving recipes in which you can use barley 
and also telling how to prepare it for infants' 
use. 



Demonstratet Its Worth. 

100 State Street, Chicago. 
The Wallace Invalid Bed Company: 

Gentlemen — Since you placed the bed in 
Mercy Hospital we have had splendid oppor- 
tunity to observe its practical application to 
the comfort of the sick and to note its great 
assistance in surgical dressings and handling 
and caring for surgical cases without causing 
pain or discomfort. 

I feel that every hospital should have a 
goodly number of these beds at the disposal 
of their patients. Yours very truly, 

Dr. J. B. Murphy. 

Aug. 9» 1909- 



ADVERTISEMENTS 



When xou write Advertisers, please mention Thb Tbainbd Nuhbk. 



C|)e Ij^M^tt'ti Besilk 



C|)e CratneDi finxat ant» 

A monthly Magazine Devoted to Trained Nursing in 
Private Practice and in the Hospitals of the Country 

Editor 

ANNETTE SUMNER ROSE 

LAKESIDE PUBLISHING COMPANY 

PUBLISHERS 



OFFICE— 114-116 East 28ih St.. New York City 



THE TRAINED NURSE 

has no free circulation. Its price is $2.00 a year, and 
it is worth it. It is published in the interest of the 
profession, screens no swindlers, putfs no humbugs, 
and does not take hatf its space to tell how good the 
other half is. 



Annual Subscription, post-paid $2.00 

Single Copies 20 

Entered aa accond-clasa matter at the New York 
Poat Office, March U, 1901. 

IMPORTANT NOTICE.— fhosTof our subscrib- 
ers who wish to notify change of address must send 
such notification in order that it may reach the pub- 
lishers not later than the 20th of die month before 
publishing; otherwise the change cannot be made. 

COMPLAINTS for non-receipt of copies or requests 
for extra numbers must be received on or before 
the 10th of the mo^rii of pii>lication ; otherwise 
the supply is apt to be exhausted. 

TO (TONTOIBUTORS^^^ 
Original Articles. 

Exclusive publication must be insured to all 
contributions offered to die Editors. Rejected man- 
uscripts will be returned if stamps be sent for this 
purpose. 

Exclusive publication not required for contribu- 
tions to Nursing World Department. 

Illustrations for articles are particularly solicited. 
All expense for drawings, plates, etc., will be borne 
by the publishers. 

No responsibility is accepted by the Editors or pub- 
lishers for the opinions of contributors, nor are they 
responsible for any other than editorial statements. 

Books and monograptis will be reviewed promptly. 

Short, practical notes upon personal experiences 
or brief reports of interesting cases, with results 
from remedies, new or old, will be welcomed. 

The Editors and printers will greatly appreciate 
the courtesy of having all manuscript typewritten; 
or. if this is impossible, clearly written, great atten- 
tion being given to proper names and medical terms. 

Copyright. 1910, by Lakeside Publishing Company. 



Pleasure, Not a Duty. 

We simply hate to talk about duty to nurses, 
for if there is any one class of people more 
than another who have duty dinned in their 
ears dismally and eternally, trained nurses are 
that class. 

And yet we would like to talk about duty, 
in this case a duty which is a positive pleas- 
ure. 

If you are not looking over the advertising: 
section of every number of The Trained 
Nurse you are really missing something. 
Those with a real appreciation of the future 
of nursing know you are missing a lot. Would 
you like to nurse without a clinical ther- 
mometer or a hypodermic syringe? Well, 
there was a time when there were no clinical 
thermometers or hypodermic syringes, and 
when they first began to come in the majority 
of people did not believe in them any more 
than they believed in anesthetics at first or 
antiseptics. But the world is not going to 
stand still, and these things have made a 
place for themselves just as some of the new 
things advertised in this issue of The 
Trained Nurse are going to make a place for 
themselves, so that in a few years they will 
become indispensable. Do not be the last to 
get acquainted with something which in a 
couple of years will become an absolute neces- 
sity in scientific nursing. 

Therefore, read the advertisements in this 
issue, send for the samples and literature so 
generously offered, get up-to-date, in fact, be 
just a little bit ahead of the majority. 

+ 
A Great Success. 

It looks as if our Prize Subscription Con- 
test was going to be a great success. We 
have already received a great many chibs, but 
there are so many working that^ up to the 
present the clubs are small. Therefore, every 
one has a chance, and you get something for 

your trouble, even if you do not win. 
When your Alumnae Association meets 

bring this Prize Offer to the attention of your 

members. Your association could use the 

prize money. 






VOL. XLV. 



NEW YORK. NOVEMBER, 1910. 



NO. 5. 



€t|)tcfi; anti Beportment for ^ttentiants on 

ilflental f n\)altti0 

CLARA BARRUS, M. D. 
ABsistant Physician in the Mlddletown State Hospital, Middletown, N. Y. 



LET US consider the deportment of 
attendants on the insane and the 
ethics of nursing this class of patients in 
our State hospitals. In other words, con- 
sider how to act in the various situations 
you encounter and, also, why it is right 
for you thus to act. Briefly, we are to 
consider what is your duty and a clearer 
understanding as to what constitutes your 
duty will, I hope, be followed by con- 
scientious performance of it. 

Our duty is to help the patients — to 
help as many as are recoverable to get 
well speedily and to make those who can- 
not get well as comfortable, happy, useful 
and well behaved as possible. 

The attendant on mental invalids is 
in a trying situation. He or she comes 
to the work with little or no knowledge of 
insanity and usually with preconceived 
erroneous notions. For example, he or 
she comes with the notion, so prevalent 
with the public at large, that the insane 
are to be hoodwinked and deceived and 
led to do things by false promises, or, if 
these methods fail, threatened or forced 
into submission. 



Please understand at the outset that 
these are bad methods. The best way 
of dealing with mental invalids is the 
honest way. Honesty is the best policy 
here. A false promise may work once, 
but thereafter your patient learns to dis- 
trust you. Again, a patient who is 
threatened may do things because of 
fear, but the threat on your part estab- 
lishes a wrong relation between you and 
him. Let your aim be to make him trust 
you, and rely upon you, to feel that you 
wish to help him in every possible way 
to be his best self. Likewise, if force 
is resorted to, if he obeys you because 
he must, then is he antagonized toward 
you, and henchforth regards you as his 
enemy, and you, in turn, by exercising 
an unwarrantable authority, are, to a 
certain extent, made tyrannical; so there 
grows up between you and the patient a 
feeling of perpetual strife, instead of ont 
of trust and mutual helpfulness. 

Your duty as attendants may be con- 
sidered under six heads: Duty to the 
patients, to the institution itself and to 
its officers, to your associates, to your- 



280 



THE TRAINED NURSE AND HOSPltAL REVIEW 



selves, to the relatives and friends of the 
patients and to the public. 

Duties to the Patients — Each patient 
is to t>e treated as a person, not merely 
as a case He is to be addressed respect- 
fully by name and title. In all relations 
with him, without undue familiarity, try 
to impress him with your friendly and 
helpful attitude, letting him understand 
that requests for certain conduct and co- 
operation on his part are because the of- 
ficers believe such to be for his good, not 
because you wish to dictate to or to con- 
trol him. Stimulate his self-respect and 
his desire to conform to normal behavior 
so that this will be voluntary on his part. 
Be his friend, and make him yours. Per- 
suade and conciliate him, resorting to 
force only when absolutely necessary, 
and then have enough help so that you 
do not injure him or receive injuries 
from him. And, when necessary to em- 
ploy force, do it calmly and quietly, con- 
trolling your own temper and voice; 
never let these episodes assume the na- 
ture of an angry struggle between you 
and the patient. 

Especial pains are needful in the recep- 
tion of patients to the institution or to 
a new location in the institution. Ex- 
plain the rules and customs to a new 
patient. All is strange, and many are 
apprehensive and suspicious on admis- 
sion. The removal of their clothing to 
be marked will be regarded as theft ; the 
first bath, unless considerately given, 
may be thought a punishment and the 
like. Make first impressions favorable. 
Timid ones need to be reassured ; the 
weak and sick to be treated with the ut- 
most consideration ; depressed patients 
call for especial vigilance to guard 
against self -in jury, and need to be 
cheered and diverted from their melan- 
choly. Excited and suspicious ones are 



to be soothed and reassured, more by 
your friendly manner and offices than 
by words, and quarrelsome, untidy, de- 
structive and dangerous ones require 
most tactful and resourceful manage- 
ment. The more troublesome a case is 
the more you are put on your mettle to 
discover the best ways of helping him. 

Only a few days on the wards and you 
become aware how much care and 
patience it requires to deal with these 
unfortunate charges, and the longer you 
stay in the work the more will this be 
impressed upon you. There will be 
times when it will be very difficult for 
you to be patient with troublesome, un- 
ruly and malicious patients. There often 
seems so much method in their madness 
and they show such ingenuity in doing 
the things they ought not to do and in 
leaving undone the things they should 
do that you get discouraged and im- 
patient, and sometimes downright angry, 
and then you find it hard to keep from 
saying and doing things which your bet- 
ter nature tells you are wrong. 

It will make it easier for you to put 
up with all the trying ways of your 
patients if you will keep continually iii 
mind the fact that they are sick persons 
— sick in body or mind, or both, or sick 
in their moral natures, even if they are 
able-bodied and are keen and alert in 
their minds and fertile in their schemes 
for annoying and exasperating you 

UnfaiHng kindness and courtesy must 
be continually sought for. The more 
troublesome the case, I repeat, the harder 
you will need to watch yourself, the more 
grace and forebearance and forgiveness 
you will need to summon. It isn't easy, 
but we are here to do the right thing, 
not the easy thing. Still, it is surprising 
how much easier it is for all concerned 
when we do do the right thing, and do 



ETHICS AND DEPORTMENT 



261 



maintain this conscientious, sympathetic 
and helpful attitude toward our often 
troublesome charges. 

Put yourselves in their places; think 
how we should feel, deprived of our 
liberty and believing that we were un- 
justly deprived; imagine how it would 
seem, for example, to be tortured all 
night long with the belief that some one 
was turning on electricity which was 
causing those pains in various parts of 
the body just to annoy us, or how we 
should feel if we heard ourselves reviled 
by the voice of some one we could not 
see, but who seldom ceased tormenting 
us in all our waking hours. These are 
only a few instances; your experience 
will suggest many others to you, and, di- 
verse as they are, the pitiful part is the 
same in all cases — the patient suffers 
just as much as though the things which 
he believes are so were really so; to him 
they are so, and his conduct is the out- 
come of his mistaken perceptions and 
beliefs of his bodily and mental dis- 
comfort and of his warped and diseased 
mentality. 

Accordingly, sympathy and not resent- 
ment, patience and not petty dictation, 
help and not punishment, are what we 
need to secure. 

We get accustomed to the sight of suf- 
fering in the wards, not so much to 
physical suffering, perhaps, as to mental 
pain. Let us never grow hardened to 
it. Familiarity with suffering should 
make finer natures more sympathetic- 
less emotional toward it, but more ready 
with means of alleviating it. 

We also get accustomed to unseemly 
conduct, to vile language and unclean 
thoughts, as well as unclean habits. It 
rests with us if these things shall brutal- 
ize and coarsen us, or make us even more 
careful that our own lives and thoughts 



maintain an undeviating standard of 
wholesomeness and cleanliness. One of 
our poets, in speaking of a hospital 
nurse, has said : 

"The gross and soiled she moves among. 
Do not make her gross and soiled. 

All departures from right behavioi 
should make us bend our energies to 
(bring the patients back, if possible, to 
self-respecting conduct. Do not be con-' 
tent to see them drift into still more de- 
plorable states. Much can be done by 
tact and ingenuity and persistence to in- 
duce decency and orderliness. 

Attendants are with the patients so 
much of the time that their power for 
good and evil is very great. Many a 
patient's restoration to sanity has been 
most largely due to the helpful offices of 
the nurse who has been on hand to stimu- 
late interest, cheer loneliness, perhaps 
correct false beliefs — not by argumnt, 
but by making the truth obvious, and, in 
countless other ways, to lend a hand just 
in the nick of time. Let but the patient 
feel that you are his friend and your op- 
portunities for good are almost incal- 
culable; but once let him feel you have 
been unjust or unkind to him and it will 
take months of continuous friendly ef- 
fort on your part to gain his confidence, 
if, indeed, you ever do in certain cases. 

Tact and insight and your daily oppor- 
tunities will indicate where you can ap- 
ply help to each case. I can only hint at 
a few. An oversensitive patient will ap- 
preciate attempts to make things easy 
for him ; a refined person will be appealed 
to by your taking pains to secure things 
or conditions that will contribute to his 
comfort and tastes; an officious busy- 
body will often become one of your most 
efficient helpers if you will make him 
feel that you rely upon him for aid and 
even advice in certain lines; a quarrel- 



282 



THE TRAINED NURSE AND HOSPITAL REVIEW 



some, cantankerous person is often won 
out of his mood by appealing to his sense 

of humor; a destructive one to his pride. 

If your patients have bodily peculiari- 
ties and deformities, or conspicuous 
faults of mind and character, use delicacy 
in reporting these conditions or delin- 
quencies. When necessary to report mis- 
conduct in their presence, seem to un- 
derstate rather than overstate or even 
merely to state them — ^not from an at- 
tempt to deceive the physician, but in a 
spirit of forebearance and excuse, thus 
letting the patient feel that you are on 
his side, and report only because you 
must to the end that the physician may 
understand his difficulties and so, to- 
gether, you may work out methods of 
helping him guard against a repetition in 
the future. 

It is the duty of every attendant to re- 
port to his superior officer any instance 
of gross neglect or cruelty or abuse that 
comes to his notice. False notions of 
honor should never deter him from fol- 
lowing this injunction. It is cowardly 
to permit things of this kind to go on and 
and not call them to the attention of the 
proper authorities. Manliness and 
womanliness demand this from you. 
If we permit one who is entrusted with 
the care of insane patients to bully them 
and we refrain from speaking in protest 
or from reporting the occurrence, we are 
virtually a party to the wrongdoing. 

Remember that all the rules and re- 
quirements are primarily for the good of 
the patients, and in your attempts to obey 
the letter of hospital rules do not lose 
sight of the spirit of them also. Make 
sure that the comfort and well-being of 
the patient are secured and do not render 
him miserable in trying to conform to 
a certain standard of excellence in any 
given direction. For example, polished 



floors free from unsightly marks and 
scratches are to be desired, as they add 
to the attractiveness of the wards, but if 
these have to be secured at the expense 
of the patient's peace of mind; if he is 
made to feel that the marks of his boot 
nails have brought down upon him the 
wrath of the nurse, then there is some- 
thing to be ashamed of in having such 
unblemished floors. A tidy room, a 
smooth counterpane are desirable condi- 
tions as a rule, but if patients are made 
to keep their rooms on dress parade; if 
the bed is too good to be lain down on 
and we find the patient trying to get a 
nap by lying on the floor or on one of the 
hard hall benches, I say, a tidy room and 
a smooth bed are a disgrace to the in- 
stitution. No need to multiply examples. 
Your care of the physical needs of the 
patient is, of course, a large part of your 
duty to him — systematic, close observa- 
tion of his functions, habits, symptoms 
and accurate reports of the same. Hazy 
observations, half-hearted interest and 
vague, unsatisfactory and inaccurate 
records and reports are unworthy of 
you. Take pride in thoroughness and 
accuracy. 

Greet your patients and associates with 

a cheery good morning; be considerate 
of the convenience of others in small 

matters as well as in great; show your- 
self willing, even at the cost of your own 
comfort, to lend a hand; be ready with 
the soft answer that turns away wrath 
and with the good humored remark that 
disarms ill-humor; refuse to listen to or 
to join in gossip; conceal your preju- 
dices; beware of favoritism; conquer re- 
sentiment and antipathies; cultivate a 
peace-making disposition; study when to 
speak and when to forebear, when to act 
and when to refrain from acting. In 
short, be your best selves. 



(To be continued.) 



^titrteisd to ^pmiel^=^^mtxmn £^ar finxstsi 



HARRIET C. LOUNSBERY. 



/^ NE more year has passed over our 
^^ heads, and we find ourselves to- 
day, I think, stronger in many ways than 
we have been. Year by year we seem to 
grow closer to each other and the re- 
turned mentbers, if here, will surely re- 
alize that their welcome is warm and 
sincere. 

I must express my gratitude to the 
society for electing such good helpers as 
the treasurer and the two secretaries have 
been. The workings of the society have 
been full of pleasure to me, though my 
helpers have done the burden of the 
work, as their reports will show. 

It has been suggested to me by a mem- 
ber, who is absent, that our society could 
collect among its members a very con- 
siderable amount of rare and interesting 
articles. That so many of our members 
have been to foreign lands and have 
brought home so many souvenirs, that, 
placed together as a collection, they 
might be accorded a corner in the Na- 
tional Museum, and from time to time 
additions might be made, and a very in- 
teresting collection result. 

I find one suggestion in the address of 
my predecessor which shall be the in- 
spiration of the few words I shall say to- 
day. In her address, read to us last 
year, I find this: *'The president would 
advise the nurses to join the Red Cross 
Society." 

At the time nurses were needed dur- 
ing the Civil War, willing women were 
put through a few weeks'- training in city 
hospitals and rushed to the front, where 
they did noble woric, but many lives were 
lost because no nurses were prepared 



^President's address at openlnig of Cosventlon 



for the emergency. In the Spanish War, 
only through the most strenuous efforts 
of many workers were the proper nurses 
selected for the Government worthy to 
be trusted with the lives of her sons. 

Now the reorganized Red Cross comes 
before us and says: "We want thor- 
oughly competent women, educated as 
nurses, to give us their names, so that 
in time of war or national calamity we 
will not have to wait for education, for 
searching and for endorsements, but can, 
with the swiftness of the telegraph, in- 
stantly summon to our aid those who 
are competent, those upon whom we 
can rely." Those who have once gone 
forth will be doubly welcome. If home 
or professional duties forbid obeying a 
summons, no questions are asked, no one 
is forced to go, but the Government 
wishes to have at hand a list of such a 
number of women, nurses tried and true, 
that at any time enough for any emer- 
gency may be found. Is this not right? 
Is it not wise? Could we of this society 
do better than to say to our country, as 
we said once before, "Here we are, take 
us." The problem of the army nurse 
was, as you know, at the outbreak of the 
Spanish War, an unsolved one. Had 
we, who went down to help our country, 
been false to our trust, had we been a 
hindrance, as many expected us to be, 
instead of the power for good that we 
were proven to be, there would now be no 
army nurse and no Red Cross nurse, 
no navy nurse and no association such as 
we see here to-day. Now the Red Cross 
' nurse is the logical outcome of the army 
nurse. If our country called us again 

at Atlantic dty^ Septembsr 20. 



284 



THE TRAINED NURSE AND HOSPITAL REVIEW 



who is here that would want to stay at 
home ; and the fact that our names were 
on the Red Cross lists as veterans would 
secure for us early calls, perhaps, not 
for the actual nursing that additional 
years may have rendered impossible, 
but for the many other positions that 
the gathering and sending of a large 
body makes indispensable. Can we not, 
as a body, send to the National Red 
Cross our hearty endorsement and in 
our several States enroll for work under 
the banner which we all reverence for 
the country we all love? I have been 
much gratified to notice that many of 
our members are on State committees; 
can we not all put ourselves once more 
in touch with the Government for whom 
we once worked so willingly? 

Perhaps I have said enough. Yet so 
many avenues of usefulness seem 
opening to nurses I must go on, if your 
patience will permit. 

In our work in the army we were 
pioneers. We did not wait for others, 
the moments were too precious, the men 
were too sick for us to hesitate. So now, 
when work calls us, we should not liesi- 
tate, because it is new or untried, but 
rather we should show by our courage 
in little trodden fields that the old brave 
spirit is still in us. The workers in the 
tuberculosis field are but few — ^the enemy 
is the most dreaded, the most deadly 
known to civilization. Yet with the re- 
searches of science it is possible to con- 
quer. With light, cleanliness, patience 
and the teaching of hygeine this scourge 
can be eliminated. How many of us go 
down to this battlefield where not only 
men, but little children and frail women 



hold out emaciated hands to us for suc- 
cor and intelligent care? And so with 
other branches of work too numerous 
for me even to mention here. Missionary 
nursing, training of foreigners, the care 
of girls in city factories, the unimaginable 
diseases caused by immorality, the gospel 
of right living to be taught by nurses to 
patients, to mothers, to girls and to boys, 
who are, through ignorance, brought 
to such sickness and suffering as only 
nurses know. All this is more or less 
pioneer work. We have done picMieer 
work and succeeded in moving such a 
migfhty machine as the U. S. Government. 
Could we not always have that as our 
inspiration and whenever there is a cry 
from any source for help, for the uplift 
of our fellows, for unusual work or ef- 
fort there I would like to see a Spanish 
war nurse showing once more to a grate- 
ful people that she realized that in times 
of peace there are battlefields and 
wounded as truly as in times of war. 

I am most proud to say that one of 
our members has gone to a far country 
and established training schools for 
nurses — three have gone to the missionar)' 
field in Turkey. One guides and guards 
about 1, 800 factory girls in a Western 
town. One voluntarily gave up her life 
to prove that the yellow fever may be 
communicated by the mosquito. Several 
went forth and helped a sister country in 
time of war; one is head of the navy 
nurses' corps ; many others there may be 
whose noble deeds have not come to my 
ears. I cannot but feel that it would be 
for the great good of our society if our 
past should be but the inspiration of our 
future. 




TYPICAL BLOCK.PLW« 



^ $lan for tf^t Consittuctton of i^artr iSutltitngd 

in CrotDtieti €itits* 



S. S. GOLDWATER, M. D. 



Superintendent, Mount Slnal Koflipltal, N. Y., ConBultlng: Supervisor of Construction to 

'Bellevnie Hospital, the Stamford Hospital, etc. 



AN acceptable plan for the construc- 
tion of ward buildings of many 
stories in crowded American cities has 
long been needed Such a plan must 
satisfy the requirements of convenient 
administration, and must comply in all 
essentials with the demands of hygiene, 
even under the hard conditions of a re- 
stricted site and of possibly unfavorable 
surroundings. The ward plan which is 
the subject of this paper is presented as 
a contribution to the study of this prob- 
lem. 

It is assumed that economic necessity 
compels us, and will compel us indefi- 
nitely, to continue to house a majority of 
hospital patients in large wards. Those 
who are opposed to large wards and who 
propose to provide for each patient the 
particular environment best suited to his 
condition and needs, are no doubt cor- 
rect in theory. A private room with a 
porch and a garden ; a private nurse on 
day duty and another on night duty; a 
skilled medical officer, not too much 
distracted with administrative duties or 
with the care of other patients — all these 
combined represent a kind of hospital 
organization which is greatly to be de- 
sired, because in the long run it would 
yield the 'best results in the treatment of 
patients acutely ill. But the folly of sub- 
dividing wards into single rooms, while 
there is a lack of means to increase sub- 
stantially the number of nurses, has been 
demonstrated to the satisfaction of more 



than one hospital superintendent, and to 
the serious discomfiture of patients in 
wards subdivided and understaffed. 

Nevertheless the necessity of a partial 
classification of patients within the 
typical medical or surgical ward group 
must be recognized, even if a complete 
and perfect classification is at present un- 
attainable; this necessity is recognized 
in the accompanying ward plan, as it is 
in all ward plans which provide, among 
the appendages, a lounging and dining 
room for convalescents, an airing balcony 
or balconies, and one or more "recovery," 
isolating, or "quiet" rooms. The prob- 
lem in ward planning is to bring to- 
gether all of these helps to good nursing 
and proper care, in such a manner as to 
facilitate their supervision by the limited 
number of nurses at present available, 
and at the same time to avoid hemming 
in the ward itself in such a way as to in- 
terfere materially with its supply of light 
and air. 

A hundred or more writers in the last 
decade have reviewed the history of 
hospital planning and have presented 
and commented upon the ward plans of 
representative hospitals in Europe and 
America. I shall, therefore, take for 
granted a knowledge of these plans and 
shall merely say that none of them, in my 
opinion — ^meritorious as many of them 
are, and admirable as some of them must 
be acknowledged to be — can be utilized 
in a wholly satisfactory way for the con- 



^A paper presented to the American Hospital Association, St. Itouis, Mo. 




^^i 



-1 l5i 






*i'il 




288 



THE TRAINED NURSE AND HOSPITAL REVIEW 



struction of a hospital of any consider- 
able capacity on such sites as offer them- 
selves, for example, on the island of Man- 
hattan, in the city of New York, where 
streets, running east and west, parallel 
each other at a distance of only 200 feet 
from north and south, and where most 
of these streets, from house-line to house- 
line, are only 60 feet in width. Within 
the limits of such a city block (and I 
confine myself to the rigorous demands 
of a typical Manhattan block, because 
while better sites, permitting greatei 
freedom in planning, are often to be 
had in other cities, worse ones for the 
erection of a large general hospital can- 
not well be imagined), we are called 
upon to plan a hospital, the wards of 
vVhich will be well lighted and sur- 
rounded by a suitable zone of aeration. 

The modern hospital must be able to 
place its patients out of doors, whether 
in gardens or roof-wards or on loggias 
or balconies. Now since in crowded 
cities we cannot have gardens, and since 
roof-wards can only be utilized for a 
relatively small number of patients, the 
principal wards must have balconies; 
and these must be so placed as to be sun- 
warmed in winter, must be accessible for 
both bed-patients and convalescents, 
must lend themselves readily to constant 
supervision, and must be so arranged as 
neither to disfigure the building nor 
greatly to darken the wards. Besides 
this, the balconies must not be too clost 
to the street. 

It is essential also, on account of the 
rapidly increasing hospital needs of 
urban communities, that the ward plan 
shall be one which, if utilized at first for 
the construction of a four or five-story 
building, will permit us to superimpose 
new wards upon the old ones without 
detriment to the latter ; and it is essential 



so to locate our ward buildings with re- 
lation to the other buildings of the hos- 
pital group, that these other buildings, 
in their turn, may be increased in height 
and doubled in capacity, if necessary, 
without any signal alteration in the 
hygienic character of the wards. 

This is not all that is required by the 
conditions of our problem. If the ward 
buildings, fronting south, can be so 
placed as to face a park or an open lot, 
well and good; but inasmuch as such 
sites are not always available, and since 
empty lots do not always remain unoc- 
cupied, our plan must be one which will 
not lose much of its virtue if open 
ground on the opposite or south side of 
the street is not available, or if such open 
ground, present at the time of the con- 
struction of the hospital, is subsequently 
covered with buildings. 

A detailed comparison of the plan 
herewith presented with others suggested 
as suitable for the construction of many- 
storied hospital buildings in crowded 
cities, would lead to a discussion of many 
complicated problems, and would carry 
us beyond the prescribed limits of this 
paper. For the present, therefore, I 
must content myself with calling atten- 
tion to some of the important characteris- 
tics of the present plan, the comparative 
value of which will no doubt be made 
plain in the subsequent discussion of its 
merits and defects. 

The use of the T-shaped ward building 
enables us to construct a full-sized ward 
of thirty-one beds (five of which are in 
^'separation'* rooms) within a space ex- 
tending only 120 feet from north to 
south, or a ward of twenty-six beds within 
a space extending 106 feet from north to 
south. If we leave to the north of this 
an air-zone of 30 feet in the one case, or 
44 feet in the other, there will be avail- 



CONSTRUCTION OF WARD BUILDINGS 



289 



able for administration and service build- 
ings, 50 feet along the line of the street 
which forms the northerly margin of a 
block extending 200 feet from north to 
south. If the ward appendages and 
main service corridor were extended in 
the axis of the ward (as in the case of 
the typical pavilion hospitals of Germany 
and Great Britain), 150 to 170 feet 
would be required from north to south 
for the ward building alone, and the re- 
mainder of the 200-foot site would be 
of little or no use. 

A study of the group plans shows that 
as much as sixty per cent of the total 
ground area of a site 200 by 200 feet, 
200 by 350 feet, 200 by 500 feet, etc., 
may be occupied by buildings with sat- 
isfactory results. 

The wards are well exposed on two 
long sides and one short side, east, west 
and south; the balconies or loggias are 
ample in capacity and have the decided 
advantage (in this cHmate, at least) of 
southern exposure. They do not to any 
appreciable extent darken the wards, and 
they are under the eye of the nurses in 
the ward; furthermore, they are so sub- 
divided that convalescent patients may 
amuse themselves without restraint on 
one balcony, while very sick bed-patients 
are obtaining the benefits of fresh-air 
treatment, in undisturbed quiet, on the 
other. Each balcony is directly visible 
from one of the principal service rooms, 
namely, the pantry or the sink-room. 
The balconies are set back at a comfort- 
able distance from the street. 

The balcony, day-room, lavatories and 
water-closets designed for the use of 
convalescent patients are grouped about 
one end of the main corridor; the isola- 
tion of the very sick takes place at the 
opposite end of the corridor, convenient 
to the principal service rooms, and en- 



tirely out of the range of observation of 
the convalescent patients and their 
friends. 

The stairway and elevator lobby is 
isolated and yet occupies an especially 
favorable location, directly opposite the 
main entrance to the ward. Visitors ap- 
proaching the ward do not pass through 
a long service corridor, but find their 
way immediately to their proper destina- 
tion. 

The principal corridor is arranged to 
serve as a true cross-ventilating corridor. 

The horizontal arm of the 'T," run- 
ning east and west, can be lengthened, 
and the vertical arm shortened, if de- 
sired, for the purpose of increasing the 
number of separation rooms and of di- 
minishing the number of patients in the 
open ward. 

A special modification of the typical 
ward plan, to meet the altered require- 
ments of a children's service, is included 
among the sketches submitted. Features 
of this plan are the observation windows 
permitting the control of the children's 
water-closets from the nurses' utility- 
room; the rooms for isolated cases or for 
babies and wet-nurses; the glass "boxes" 
for semi-isolation within the large ward ; 
the larger bathroom, to accommodate 
bath tub and slab. 

Bridges may be carried from the ward 
buildings to the north, east, or west, 
without detriment to the wards. In a 
group plan including two ward buildings, 
a bridge to the east or west would give 
convenient access to a central administra- 
tion building. In a group plan including 
but one ward building, a bridge to the 
north would communicate with an ad- 
ministration building facing the northerly 
street ; in a larger group plan, bridges to 
the north would communicate, according 
to the details of the general scheme, with 



290 



THE TRAINED NUKSE AND HOSPITAL REVIEW 



an administration building, kitchen and 
laundry building, pathological laboratory, 
operating pavilion, out-patient depart- 
ment, or with buildings used for any 
variety or combination of the purposes 
named. 

In the larger and more ctMnplete 
group plans a separate out-patient build- 
ing, not too high, would be placed at the 
southeast or southwest corner of the 
block and would be balanced by a private 
patients' pavilion at the opposite comer, 
leaving the ward buildings well exposed. 



The essential feature of the scheme 
herewith presented, in which it differs 
from any published or applied ward plan 
known to the writer, is the combination 
of ward and balcony in a T-shaped plan, 
which, under the common conditions of 
hospital construction in crowded cities, 
seems to offer advantages not otherwise 
attainable. 

I am indebted to Messrs. McKim, 
Mead & White for kindly permitting me 
to have the accompanying drawings pre- 
pared in their office. 



ADULT AND I 



ANT DOLL USED FOR NURSES PRACTICAL CLASS WORK, FREDERICK FERRIS 
THOMPSON HOSPITAL, CANANDAIGUA, N. V. 



DoUb were made iby taking underg-arments, 
glovea, and flntog them with oott"- ■"'' ""« *• 
whole body " 



and drawers, Btocklns'B and cOttOD 

ake the neceesarr weight. Over the 

>n which woe applied four coats at Bhellac 

face, and real hair wig completes the head. 



a year, and has stood tlie 



C|)e Hospital Contientton tj^ihit 



^ I ^HE first exhibit of its kind in con- 
^ nection with the American Hospi- 
tal Association started out under rather 
unfavorable conditions for lack of time. 
Seven weeks only were available for 
preparation, but in that time sufficient 
was achieved to show the splendidly 
interesting and valuable possibilities of 
this feature of the convention. The 
Washington University Hospital of St. 
Louis made the largest contribution. So 
practical and valuable were the exhibits 
from the obstetrical and surgical depart- 
ments of this hospital and so many 
visitors were desirous of fuller detail re- 
garding technique in those departments 
that arrangements have been made with 
Miss Menia Tye, Superintendent of the 
Training School, for a description of the 
manner in which several of the exhibits 
are used in the daily routine. This ar- 
ticle will probably appear in the Decem- 
ber number. 

The nurse superintendents were es- 
pecially interested in a collection of ar- 
ticles showing how that hospital pre- 
pares for emergency labor cases. The 
method of preparation will be fully 
described in Miss Tye's article. 

An anesthetizing apparatus designed 
by Dr. J. Ross Clark was shown. This 
apparatus is said to have the following 
advantages: The anesthetizing agent is 
warmed, there is no rebreathing, accurate 
dosage and even mixture of air and gas 
is provided for, the anesthetist has his 
hands free to care for the patient, only 
a small part of the patient's face is 
covered, permitting cyanosis to be de- 
tected in its onset. 

The method of preparing Dr. Crossen's 
gauze-strip sponges for abdominal sec- 



tion with a view to eliminating the possi- 
bility of any gauze being left in the abdo- 
men was shown. This method was fully 
described and illustrated in an article by 
Dr. Crossen in the January (1910) num- 
ber of The Trained Nurse. 

A hypodermoclysis outfit which the 
Washington University Hospital has 
made to order was also shown. A 
catheterization tray showing the routine 
arrangements for catheterization was an- 
other interesting thing, of which a fuller 
description will be given later. In addi- 
tion there were novel electrical ap- 
pliances, specimens of bandages, new 
drainage material and various other ar- 
ticles connected with the surgical depart- 
ment — the whole forming a splendidly 
practical contribution for the benefit of 
the convention visitors. 

St. Luke's Hospital contributed speci- 
mens of invalid solitaire boards which 
they have found useful, home-made float- 
ing labels and a record holder. 

In the Jewish Hospital (St. Louis) 
exhibit the feature that attracted most 
attention was an eye-tray designed by 
Dr. Wiener and made to order. It 

■ 

was of white enamel with depressions 
for a row of small bottles containing 
such drugs and other articles as are or- 
dinarily used in eye operations, treat- 
ments and dressings, the whole making a 
most convenient and inexpensive outfit 
for ophthalmic treatments. Many of the 
visiting superintendents there on seeing 
it announced their intention of having 
one like it for their own institution. 

Dr. Homsby, of Michael Reese Hos- 
pital, Chicago, contributed a child's bed 
designed by himself. The spring mattress 
can be raised and lowered, and an auto- 



292 



THE TRAINED NURSE AND HOSPITAL REVIEW 



matic lock which holds the spring at any 
point desired prevents any possibility of 
accident from the unexpected dropping 
of the springs. 

Buffalo General Hospital sent a model 
of a ward partition which they are using 
with great satisfaction, a new form of 
castor and specimens of ward dressings 
prepared so as to lessen the quantity of 
gauze used by 33 1-3 per cent. 

The U. S. Navy Department sent an 
exhibit of plans of a new naval hospital 
under construction which embodies some 
interesting and rather new features in 
construction and a photographic exhibit 
of naval hospital appliances and methods. 
One of the most attractive features in 
the exhibit was sent from the New York 
State Hospital for Crippled Children, 
West Haverstraw, N. Y. It was a model 
of a shack used in outdoor treatment of 
children afflicted with tuberculous dis- 
eases of joints and various deformities. 
In the shack were six beds, and on six 
patients (in miniature) there were dem- 
onstrated something of the newer meth- 
ods of deaHng with different classes of 
diseases and deformities. The whole 
outfit was most complete and showed 
that much effort and thought had been 
used in its arrangements. 

The New England Baptist Hospital 
contributed a model of the tents used in 
their out-door ward, with furnishings 
complete, even to the telephone beside 
the patient's bed. Just outside this model 
tent, with its model furnishings, was a 
model nurse, who stood attentively on 
duty attired in a very practical sort of 
rainy-day uniform. The nurse and the 
tent received enough attention and ad- 
miration for the common sense planning 
which they represented to make the su- 
perintendent vain, if she were not proof 
against any such emotion as vanity. 



ADULT AND INFANT DOIJ, USED f 
NURSKS' PRACTICAL CLASS WORK. 



ADULT CRin BED FOR TYPHOID PATIENTS (OPEN). 



ADUI.T CKIIJ BED FOR TYPHOID PATIENTS (cLOSEd). 

This aduJi crib bed was designed for mildly delerious patients, to 
do away with [he neceoslty for rest stheel* or tying- In bed. The 'bed Is 
^'J.i' ,.1?'"'' afrong Iron bed, of h(WT>ltKl size and height, but jirovlded 
with Bllding slda. whch can be held at any aoBlrable height. The add- 
ing control, however, being placed undemBath where the patient cannot 
easily reach It. This toed has been used for a couple of yea™ with entire 
satlBfactlon tor typhoid and other Irresponolble patlsnts, mia Hoapltal 
Supply Company, New York, made these beds from our susgefltlons. 



294 



THE TRAINED NURSE AND HOSPITAL REVIEW 



Bronson Hospital, Kalamazoo, con- 
tributed a curette sheet which may also 
be used for obstetrical delivery. A sur- 
gical soap container, designed by Di. 
Balch, of that hospital which, when fixed 
above the stationary wash-bowl, fur- 
nishes soap on pressure of a rubber bulb 
with the foot, is worthy of special men- 
tion. This useful little invention can 
be made at home by any hospital at very 
small cost. An inexpensive home-made 
bed-pan rack, which can be used for 
either the slipper or the "perfection" bed- 
pans, was also shown. 

An exhibit of the cartoons used in 
Buffalo, Troy and other places raising 
money for hospitals quickly and in large 
amounts, proved interesting to many of 
the workers. It was sent by Mr. G. W. 
Johnson, of Buffalo, who conceived the 
plan and has successfully carried it out 
in different places. 

In the photographic exhibit two or 



three features are worthy of special 
mention. Mr. Mark Pendergrass, of Salt 
Lake City, illustrated by photograph their 
method of handling typhoid fever cases 
in tents. (See photos and description 
elsewhere in this number.) 

Miss E. K. Kraemer, of the Frederick 
Ferris Thompson Hospital, Canandaigua, 
N. Y., sent photographs of a bed de- 
signed by herself for use in managing 
mildly delirious patients ; also of an adult 
and an infant doll made by herself, 
coated with shellac, which she has found 
exceedingly useful in giving practical 
demonstrations of baths, poultices, etc., 
in teaching nurses. 

The whole exhibit was so practical and 
interesting that promises of contribu- 
tions for next year were numerous. It 
is predicted that an exhibit hall as large 
as the convention hall will be needed to 
care for the exhibit at the convention in 
New York next year. 



The Passing of the Cradle 



And now they tell us that it is no longer 
right to put babies to sleep in cradles. The 
new hygiene says that rocking babies is un- 
healthy. They should be laid down in station- 
ary beds, with pasteurized pillows and steril- 



ized sheets. The hand that has heretofore 
ruled the world will have to do it in the future 
by some other means than by rocking the 
cradle. The lullaby of the future may run 
something like this : 



Sleep, little one, sleep, 

Safe in your germ-proof bed; 
Mother her watch will keep 
Over your slumbering head. 
Naughty bacilli you need not fear, 
Bugaboo microbes will come not near. 
Mother will chase all these away. 
Sleep, little one, till the break of day. 
— From The Chicago Tribune. 



2,efli0on0 in Ctiemtsitt^ for fiux&t& 

MINNIE GOODNOW. 
Superintendent Bronson Hospital, Kalamasoo» Iffleli. 

LESSON IV. 



ACIDS are compounds of hydrogen 
and non-metallic elements. Some 
of them, however, contain a metal and 
many have oxygen in addition. They 
have a sour taste and turn blue litmus 
red. (Litmus is a vegetable extract ob- 
tained from a species of lichen.) 

The three most common acids are sul- 
phuric, nitric and hydrochloric. Their 
formulae are as follows : 

Nitric acid HNO, 

Sulphuric acid H2SO4 

Hydrochloric acid HCl 

(Carbolic and carbonic acids are not 
true acids, though called by that name.) 

Nomemclature. There may be two 
acids containing the same elements, but 
in differing proportions. In this case 
the name of the one having the lea|st 
oxygen ends in ous, the other in ic. For 
example, H^SO^ is sulphuric acid, 
HgSOj sulphurous. HNOg is nitric 
acid, HNOj nitrous. Their compounds 
are named in a similar way: Calomel is 
meToirous chloride, corrosive sublimate 
is mercuric chloride. 

Bases are compounds of oxygen, 
hydrogen and a metal. They have an 
acrid taste and turn red litmus blue. A 
base which is readily soluble in water is 
called an alkali. 

An alkaline reaction is the turning of 
red litmus blue. 

An acid reaction is the turning of blue 
litmus red. 



It will be seen from this that acids 
and bases, or acids and alkalies, have 
opposite characteristics. 

A substance is said to have a neutral 
reaction when it is neither acid nor 
alkaline, i. e., does not affect either red 
or blue litmus. This may be illustrated 
as follows: 

Put a small amount of dilute caustic 
soda (a strong alkali) into a dish. Add 
to it hydrochloric acid drop by drop, 
stirring with a glass rod. Test frequent- 
ly with litmus paper, both red and blue. 
If the acid is put in carefully we can 
obtain a solution which will change the 
color of neither kind of litmus and is 
therefore neutral. 

(The reaction is NaOH+HNOs =- 
NaNOs H,0.) 

Alkaloids are plant bases. They are 
complex compounds containing nitrogen 
and carbon, and 'having qualities very 
like bases or alkalies. They are the 
"active principles" of the plants from 
which they are obtained. A plant may 
produce more than one alkaloid; forj 
example, morphine, codeine and heroin 
are all alkaloids of opium. Alkaloids 
are usually violent poisons, and when 
used medicinally are given in very small 
doses. (See lesson X.) 

Salts are compounds produced by 
completely or partly replacing the hydro- 
gen of an acid with a metal. They may 
be made by combining a base and an 



2% 



THE tRAINED NURSE AND HOSPITAL REVIEW 



acid. The following equations illustrate 
how the reactions occur: 



NaOH + HCl 

Sodium hydrate acid 
(metallic comp.) 

2NaCl + H2SO4 
(metallic comp.) acid 

Zn + H^O« ■ 

metal acid 



- NaCl + H,0 

common salt water 
(salt) 

= Na«S04 + 2HCI 

salt another acid 

= ZnSO* + 2H 

salt 



(The English words salt and salts 
have three different meanings, which 
should be clearly distinguished. Common 
salt is familiar. A chemical salt is a 
compound formed as stated above. 
''Salts" is the name given to various 
drugs having a purgative action, usually 
salts of sodium.) 

Nomenclature. The names given to 
the various salts correspond to those of 
the acids from which they are derived. 
Acids whose names end in ic form salts 
ending in ate. Those with names ending 
in ous form salts ending in ite. Thus 
KNO3 ^^ potassium nitrate, KNC^j 



• . • 



potassium nitrite. 

Double salts are those in which two 
metals replace the hydrogen of an acid. 
Rochelle salts is an example of this, its 
chemical name being sodium and potas- 
sium tartrate 

Crystallization. Most salts occur in the 
form of crystals. Why certain sub- 
stances take this form is a matter not 
well understood. It happens whether the 
salt is a natural or an artificial product. 

As a rule, each substance has one par- 
ticular shape of crystal which it always 
assumes. They are large or small, ac- 
cording to circumstances. 

The following experiments illustrate 
the formation of crystals : 

Make a hot saturated solution of sal 
soda. Cool it and note the crystals 
which are formed. Do the same with a 
hot solution of alum. Note the different 



shapes of crystal which each solution 
gives. 

Mix powered alum and powered cop- 
per sulphate, and make a hot saturated 
solution of the mixture. When this is 
allowed to cool two kinds of crystals, 
blue and white, of two different shapes, 
are formed. This experiment shows m<5 
how natural crystals of pure substances 
are formed; advantage is also taken of 
this when we wish to obtain a pure salt 
from a mixed solution. 

(These experiments take considerable 
time, and 24 or 48 hours should be al- 
lowed for them.) 

Nearly all crystals arc formed in exact- 
ly this way, by the evaporation of a solu- 
tion either by natural or artificial means. 
Often in the process water is added to 
the elements forming the crystalline com- 
pound, not making a chemical combina- 
tion, but simply a physical addition. This 
is called "water of crystallization," and 
is easily removed without disturbing the 
chemical compound. 

Place a few large crystals of copper 
sulphate on a piece of tin and hold it over 
a flame. The water of crystallization 
evaporates and a pale blue, almost white, 
powder remains. This is still copper sul- 
phate, and the color may be restored by 
adding a little wat^r. The same "ef- 
florescence" takes place slowly if the 
substance is left exposed to the air. 

The opposite occurs in other crystals. 
Instead of giving up water to the air they 
take it in from the air, and literally dis- 
solve themselves. If a small amount of 
potassium acetate in crystals is placed on 
a bit of paper and left open it will in a 
comparatively short time begin to soften 
and will presently become a liquid. Sub- 
stances which do this are called hygro- 
scopic or deliquescent, and should al- 
ways be kept in air-tight bottles carefully 
corked. 



Cj)e purge's; lE^arUtolie 



ANNE A. WILUAMSON, 
Superintendent of Nurses, California Hospital. 



ft 



The apparel oft proclaims the man." 



TI/HAT a nurse may wear seems at 
^ ^ times to interest the lay mind as 
well as other things regarding her mode 
of life. 

A very accommodating public has al- 
ways been ready to arrange the affairs of 
the nursing world, and it will gladly at- 
tend to this matter forgetting that be- 
cause a woman devotes her life to the 
care of the sick and unfortunate it is 
not a good and sufficient reason that she 
must confide herself to a few styles of 
wearing apparel, crushing out all her 
natural delight in pretty clothes. 

Doubtless the idea originated from the 
fact that the first nursing was done by 
sisters who wore their habits, nor were 
they allowed any other garments. 

The lay public calls loudly for the uni- 
form on all occasions, even suggesting 
that a street costume be designed, 
adopted and prescribed by law for all 
nurses, these uniforms to be worn on all 
occasions so that a nurse need never be 
lost to sight and must carry the unmis- 
takable signs of her profession constantly 
with her. 

Just what the penalty for not conform- 
ing to this ordinance shall be has not 
been fixed upon yet, but no doubt that 
point will be settled later, and just what 
the consequences might be should a nurse 
escape in citizen's clothes and proceed to 
enjoy herself with her kind has never 
been determined. 

No one has ever ventured to design a 
costume for doctors or teachers, each 
being allowed to exercise his or her own 



taste in the matter with no comment from 
the outside world. Why may nurses not 
have the same privilege? 

While the nurses* uniform appeals to 
the romantic mind, and while those blue 
dresses, white kerchiefs and jaunty caps 
are very restful and appropriate for the 
wofk, no woman in this free country 
should be compelled to wear them con- 
stantly if she does not care to do so. 

The feminine mind tires of simplicity 
and straight lines, and while she may 
gladly accept the uniform in the same 
spirit that the business woman does the 
tailor-made dress, when the day's work 
is done her tastes lie in other directions. 

On being accepted into the training 
school the probationer appears in uniform 
for the first time, and never again during 
her career as a nurse will she feel proud- 
er or better dressed than on that first 
day. 

Usually she has her photograph taken 
at once so that she can always preserve 
on paper the reproduction of that first 
uniform. 

Then comes the temptation to wear 
the uniform on all occasions. It is so 
easy to do errands near the hospital with- 
out changing one's dress, or such a saving 
of time to put on a long coat and take 
the car downtown without the effort of 
making oneself more presentable, and 
possibly there may be that pardonable 
pride in the uniform and a desire that 
others may see it. 

Dear girls this is all wrong. Your uni- 
forms may be very neat and pretty and 



298 



THE TRAINED NURSE AND HOSPITAL REVIEW 



very becoming, but they are your work- 
ing dresses and should not be worn in 
public any more than the kitchen aprons 
the careful housewife always provides 
for her work, for you must bear in mind 
that a woman of fine feelings will not 
make herself conspicuous at any time by 
her dress. 

Looking at the matter from a hygienic 
point of view a uniform worn on the 
street and exposed to the dust and dirt 
of a large city is not fit for the sick room. 

In the hospital nurses do not lay aside 
their uniforms as readily as they should. 
In so many training schools it has become 
a habit for the entire school, from the 
superintendent down, to attend the enter- 
tainments in uniform and some of them 
go further than this, and grace even the 
alumnae meetings and entertainments in 
uniform. 

Laziness is the firs* ?xcuse, too tired to 
change, some say, when in reality too 
indolent is the real reason, for a change 
from the working clothes to those asso- 
ciated with happier hours is a recreation 
in itself. 

Some nurses feel that an evening 
dress is an unnecessary luxery, but when 
we consider an organdy that may be pur- 
chased for fifteen cents a yard and made 
by the girl herself, will give the wearer 
just as much pleasure as a creation from 
Paris, we feel that a simple evening dress 
is within the reach of all. 

Nurses are apt to be careless about 
their uniforms, some not seeming to real- 
ize that they are not pretty or attractive 
unless pereotly fresh. A soiled or stained 
apron is very annoying to a patient, while 
a dress without buttons or one that is 
ragged or patched destroys the idea of 
trimness we always associate with the 
nurse. 

In connection with the uniform be care- 



ful about the underskirts, for nothing 
can detract from the freshness or beauty 
of any dress as a soiled or untidy under- 
skirt. 

If the dresses are colored white skirts 
are not imperative when the laundry bills 
must be considered, but they should be 
made of material that can be washed 
and starched. Never wear a silk petti- 
coat or a cotton one that cannot pass 
through the laundry as often as the uni- 
form itself. 

It seems hardly necessary to add that 
white underskirts should always be worp 
with white dresses, but I have seen 
nurses put on fresh white dresses over 
dirty black or colored skirts and wonder 
why they do not present a well-dressed 
appearance. 

Be careful of your shoes ; do not think 
any old shoe will do with the uniform. 
Fancy shoes that have seen better days 
are entirely out of place on duty. Shoes 
should be comfortably plain and have 
rubber heels, and above all not squeak. 
So many houses now have hard wood 
floors and the tap of the nurse's heels is 
very annoying to the nervous patient, to 
say nothing of the careful housekeeper's 
distress for fear her floors are being 
ruined by possible unprotected nails. 

Granted that the uniform is only for 
use in the sick room we come to one of 
the most important parts of the question 
— what to wear after graduation. 

The majority of graduate nurses find 
that white is more satisfactory than the 
regular hospital uniform. It is more ac- 
ceptable to both the patient and the fam- 
ily, especially if the nurse must come in 
contact with the household Personally, 
I prefer white, but I always keep a few 
gingham dresses for night duty, as I find 
the colored dresses more acceptable to 
the patient during the dark hours. 



THE NURSE'S WARDROBE 



299 



Then there is the question of caps; 
aside from sentiment there is no more 
need of a nurse wearing a cap than a 
doctor. It is very becoming, but it has 
no actual use and may be omitted without 
injury to the patient. A great many 
patients object to a cap, and a nurse 
should be tactful enough to notice this 
and dispense with one when she knows 
it is undesired. 

Uniforms in a hotel, of course, are 
tabooed, a white one is permissible in 
the patient's room, but do not wear it to 
dinner, for a white uniform or even a 
plain white dress at dinner would be 
equivalent to going down in cap and 
apron as far as identification with the 
profession is concerned. 

The management of every large hotel 
strongly objects to a nurse being thrust 
upon its guests, so if you go to dinner 
and have no suitable dress wear your 
street dress and all will be well. 

Besides her uniforms each graduate 
nurse must provide herself with suitable 
clothing for the night. She must have 
a pair of bedroom slippers that will not 
come off at every step and a comfortable 
wrapper or dressing gown. Kimonas are 
not fit for the sick room, especially if 
the patient be a man. The dressing gown 
should be made of some dark warm ma- 
terial, should have sleeves that cover the 
arms and a belt. Dressed in this manner 
a nurse may go anywhere about the 
house that may be necessary. 

Should you nurse in a country where 
the climate is changeable provide your- 
self with a long-sleeved undervest to 
wear under the uniform when cold, thus 



doing away with the necessity of wearing 
a shawl. 

During the long convalescence when 
a nurse is retained for ornamental pur- 
poses only it is well to wear one's white 
uniforms during the morning or the 
greater part of the day, dressing foi 
dinner if such be the custom of the 
family. 

If your patient has been ill a long 
time she will enjoy seeing you in some 
other dress. Of course, if you drive or 
walk with her the change must be made 
earlier in the day. 

White uniforms are made of all kinds 
of material, but the most satisfactory 
ones are those made of linen sheeting, 
and if you get the coarse quality it will 
not wrinkle. 

Dresses made in one piece are most 
convenient and less expensive to launder, 
and if a permanent collar is used with a 
detachable turnover collar a great deal 
of wear will be avoided around the neck. 
Detachable buttons are better than per- 
manent ones, as pearl buttons do not 
wash and boil very well. 

Above all, bear in mind that the same 
rule applies with uniforms as with other 
dresses, that the plainer the dress the 
more carefully must it be made. 

Almost any dressmaker can make a 
dress where ruffles and other trimming 
may be used to hide deficiencies in work- 
manship, but the dress with the severe 
lines must be designed and executed by 
an artist, or the result looked for will be 
marred and irregularities will destroy the 
effect desired, namely, "sweet simplic- 



ity. 



>i 



€m 



i 



Cent tOSattrsi for C^ptioiti :febet patients at 
i^t. iEatk'fii l^odpttaU l^alt ILake Cttp 



'TT^HERE have been so many objec- 
-■- tions raised against handling 
typhoid fever cases in hospital wards, 
with the possibility at all times of the in- 
fection spreading to the other parts of 
the hospital, that St. Mark's Hospital of 
Salt Lake City is now experimenting with 
an outdoor treatment for these cases. 

In order to give the plan a fair test 
everything has been made as complete as 
possible. The tents are made of heavy 
canvas, both ends of which are a frame 
work of wooden construction, covered 
with wire screen, insuring freedom from 
flies. The sides are carefully tacked to 
2x4 inch plates laid along the floor. The 
flaps at each end of the tent are open to 
the top, giving perfect circulation of pure 
air and are so arranged that they may be 
drawn down and fastened during cold, 
windy or stormy weather or during the 
period when baths are being given. 

A double ridge pole is used so the tent 
fly is held about 6 to 8 inches from the 
roof of the tent, thus allowing ample air 
circulation between the roof of the tent 
and the fly, affording protection from the 
heat of the sun during the day. 



The floor and all frame work above it 
are so constructed that all may be taken 
down and stored when not in use. 

It will be observed that three tents 
are used — two for wards and one for the 
use of nurses. Each of the ward tents 
will accommodate ten patients. The 
nurses' tent is divided into compartments 
and contains rooms for toilet and bed 
accessories, sterilizers, electrical heaters 
and general equipment necessary to 
prompt and efficient care. 

All tents are equipped with electric 
lighting and heating, cooking equipment, 
etc. 

The slop sinks in each tent are set 
flush with the floor so that the portable 
tub may be emptied directly into the 
sewer. 

A portable tub of special device has 
been constructed for use in these tents. 
The tub itself is of heavy galvanized iron, 
7x28 and 14 inches deep. This is sup- 
ported on a frame work of hollow tubing, 
the whole being light yet strong. 

One special feature is a sterilizer for 
treating not only all excremental refuse, 
but also the vessels used, thus preventing 
contaminations of even the sewer. 



Practical Points 



The fan bath or air bath is a useful method 
in dealing with persistently high temperatures 
in typhoid fever. The method ordinarily 
used is to apply the cold, wet sheet pack and 
set in motion close to the patient an electric 
fan. Evaporation is rapid under such 
measures, and the general results are excel- 
lent. 



One of the best things as a cure for con- 
stipation in the aged and little children, is a 
baked banana taken before breakfast in the 
morning. Take a ripe banana and slit the 
skin down, then put on a plate in the oven, 
bake until quite soft, turn it out of the skin 
and eat while warm; some people like a little 
sugar on it. 



TENTS FOR TYPHOID FEVER PATIENTS, ST. MARK S HOSPITAf-, SALT LAKE CITY, 



TENT SCENE, ST. MARK S HOSPITAL, SALT LAKE CITY. 



Co Catfietett^e a female patient 



Standing Orders, Washington University Hospital, St. Louis. 



1. Boil for five minutes two catheters, 
one glass and one rubber together with 
eight cott(xi balls and one piece of gauze 
in one pint of water in the catheter 
basin. 

2. Leave the catheters, cotton balls and 
gauze in the water in which they have 
been boiled and place the basin in the 
tray. 

3. Besides the basin have on the tray 
one pus basin for urine, twp small basins, 
one to contain 1-3000 bi-chloride, the 
other to receive soiled cotton balls; also 
have a bottle of sterile glycerine to be 
used as a lubricant when necessary. 

4. Screen the bed, take into the room 
the tray and three blankets. 

5. Flex the knees and cover each leg 
with a blanket, use the third blanket to 
protect the chest. 

6. Place the pus basin to the buttocks 
to catch the urine and the empty basin 
close below it for soiled cotton balls. Re- 
move the stopper from the glycerine bot- 
tle, also the lid from the catheter basin. 

7. Scrub your hands in the wash-up 
room, using soap and brush for two 
minutes, then soak for one minute in the 
Bich. sol. 1-3000, which you have pre- 
pared for that purpose by the bedside. 

8. Take your place on the right hand 
side of the bed. Wipe off the vulva with 
a boiled cotton ball, then with the thumb 
and first finger of the left hand separate 
the labia and cleanse thoroughly, always 
making a downward stroke. 

9. Do not use a cotton ball twice. 

10. Place a cotton ball at the vaginal 
orifice. 



11. Without removing the left hand 
rinse the right hand in the Bich, sol. 

12. Pick up the catheter, but do not 
touch it within 3J/2 inches of the eye 
opening. 

13. Insert the eye of the catheter into 
the meatus, using no force, very slowly 
and carefully, until the urine begins to 
flow. Should the urine cease flowing be- 
fore a reasonable amount has escaped in- 
sert the catheter a little further. 

14. Should the catheter by accident 
come in contact with anything before 
reaching the meatus reboil it and wash 
up again. 

15. Should a catheter specimen be or- 
dered boil the specimen bottle with the 
catheter, place the end of the catheter in 
the bottle to catch the urine. Should a 
glass or metal catheter be used attach a 
piece of rubber tubing to the catheter. 

16. In withdrawing a rubber catheter 
pinch it to prevent the escape of its con- 
tents. If a glass or metal catheter is used 
prevent the escape of its contents while 
withdrawing it by placing a finger firmly 
over the end of it. 

17. After removing the catheter place 
it in the basin with the soiled balls. 

18. Before removing the l^t hand re- 
move the cotton at the vaginal orifice and 
then cleanse the parts thoroughly. 

19. Apply the vulva pad and the 
binder. 

20. Remove the basins and put them 
on the tray; cover the patient, removing 
the screen, the blankets and tray as quick- 
ly and quietly as possible. Wash and 
boil the catheter and dry it before putting 
it away. 



Cemperature Ciiattsi antr 3Bety0ibe ^oted 



lONA G. WILKINS. 



'^^OTHING is more characteristic of 
-*- ^ a nurse than her manner of keep- 
ing bedside notes and temperature charts, 
and if instead of legible, well-expressed 
notes and tidy, accurate charts, a physi- 
cian is forced to wade through ink- 
stained, incoherent statements or trace 
the course of a temperature on a chart 
disfigured with erasures and blots, no 
one will blame him if the nurse respon- 
sible for such conditions is not asked to 
work for him a second time. 

Bedside notes act as day to day records 
of prescribed treatments, medicinal, diet- 
ary, etc., and should at the same time 
contain full information of everything 
that has any bearing on the case. 

There are many varieties of bedside 
notes, but the best, I think, are those 
which have ruled spaces for time, tem- 
perature, pulse, respiration, urine, stools, 
medication, nourishment and treatments, 
and a wide margin at the right hand side 
for remarks, with a space at the top of 
the sheet for the patient's name and ad- 
dress and the date. 

Some nurses write the doctor's orders 
at the top of the sheet, but it is a much 
better plan to have a small book for that 
purpose, and asfk the doctor to write his 
orders therein, or if you write them at 
his dictation, have him read and sign 
them. 

Needless to say, all medicines, nour- 
ishment and treatments should be 
promptly charted at the hour when they 
are given. When there is less than an 
hour's interval between dosage (say an 
order for calomel gr. ss. in i-io gr. every 
fifteen minutes), space and time will be 



saved if it is recorded this way in the 
medicine column: 

Medication 

Calomel, gr, ^ 

c 3—3.15—3.30—3.45—4.00 

Space may also be saved, and a clearer 
relation established between treatments 
and their effects if they are noted in this 
way: 



Treatment 

Hot pack 20 minutes (perspired very freely) 
Normal saline O^ per enema. 

{Retained yi hr. 
Expelled clear e 
Small amount of flatus 



} 



There at a glance can be seen the treat- 
ments given and the results, without hav- 
ing to forage for knowledge in the col- 
umn of remarks. Right here is a good 
time to talk a little about the "remarks." 
They should contain the maximum 
amount of information in the minimum 
number of words. Everything possible 
should be brought to a mathematical 
base. I know a nurse who once wrote 
in a report, "Patient vomited quantity of 
dark brown fluid." "Miss A.," said the 
doctor, "how much is a quantity — eight 
ounces or a hogshead ?" 

Doctors are all Gradgrinds — ^they are 
lodring for facts, and indefinite state- 
ments and generalizations have no place 
in their scheme of things. I read a night 
report recently which had the following 
lucid remark: "Slept fairly well — com- 
plained of pain in right side toward 
morning." Now, "fairly well" might 
mean three hours to me and five to some- 
one else, and after much questioning I 
elicited the following: "The patient 



304 



THE TRAINED NURSE AND HOSPITAL REVIEW 



slept at intervals from 9 to 2 A. M. — 
total amount of sleep about three and a 
half hours — woke with shooting pain in 
left intercostal region, which lasted half 
an hour." 

When anything of unusual significance 
occurs underscore your note of it in red 
ink, so that the doctor's attention will be 
called to it at once, while it will not be 
necessary to discuss it two freely in the 
patient's hearing. 

At the end of each twenty-four hours 
a summary of medication, nourishments, 
treatments, urine, stools, together with 
the highest and lowest temperature, pulse 
and respiration should be made. This is 
invaluable as a comparison from day to 
day, and should never be omitted. 

If your writing is not easily read it is 
a good idea to adopt the plan in vogue at 
some training schools — that of printing 
instead of writing your entries. It doesn't 
take any more time when one is. accus- 
tomed to it, occupies less space and is, of 
course, much more easily read. 



While the bedside notes furnish de- 
tailed data of a case, the temperature 
chart, being a record of the three most 
vital symptoms, is of primary import- 
ance. It should be neatly kept, if ruled 
in black temperature dots should be 
made in red ink and with the connecting 
lines in black. Always rule heavily the 
lines used to divide the twenty-four-hour 
spaces, so that the division into days 
may be easily seen. 

Drop temperatures produced by 
sponge baths, packs, etc., should be 
traced in red ink below the original tem- 
perature, and a note of the treatment 
written above it. Antipyretics should 
also be recorded on the chart; also any 
marked change in diet — in fact, any 
treatment or occurrence that would have 
an effect on a temperature either way. 

If the physician does not wish to keep 
them, notes and temperature records 
should be either safely filed away or de- 
stroyed by the nurse who has had charge 
of the case. 



Ttie Call of the Wood«. 



When you are tired ministering to the many 
wants of the sick; and thmgs seem to go all 
wrong, take a day "off,** and go to the coun- 
try where nature is all harmony and unison, 
and there let your body relax and your soul 
expand and rest; often the spirit as well as 
the body requires rest 

The green mountains will speak their mes- 
sage, the waterfall its music, listen to its 
rhythm; flowers invite your admiration and 
give you in return their sweetest perfume; 
the sky albove is clear and restful 



Nature is all giving, for the scent of youUg 
growing things, the gentle rustling of the 
leaves, songs of birds, all is soothing to tired 
nerves. To a nurse it is the frequent contact 
with irritating, and often uncongeneal, forces, 
which consumes the vitality, and leaves us, as 
we say, "limp" and nervous. 

Nurses, I think more than any one' else, 
require this nature diversion, as our work 
keeps us confined very much indoors. Try 
this outing sometime and see the effect 

MvRA IsoBEL Stevens. 



die Stet littctien 



The Need of Careful Selection and Preservation of Pood-Producta to 

be Used for the Sick 



MARY H. TUFTS. 



(Continued from October.) 



ON another case in the country, where 
I was, by the doctor's order, feed- 
ing a very sick patient largely c«i milk 
prepared in varied ways, my suspicions 
were aroused in regard to the milk 
(which was bought of a milk-man) be- 
cause it had a peculiar, slightly pungent 
odor, and on standing some hours would 
separate into cream and a bluish, watery 
fluid that did not look like ordinary skim- 
milk. The flavor was peculiar, but inde- 
scribable. I complained to the man who 
brought it, and he was most indignant, 
though I explained as tactfully as I could 
that I feared his cows were getting some 
kind of feed that had affected the milk. 
For a few days after my complaint the 
milk was O. K. in flavor and appearance, 
then began to look and taste as before. 
About this time my patient complained 
much about a burning sensation and pain 
in stomach and bowels. I had told the 
attending doctor about the milk, and 
now told him that I wished he would ask 
the family to get milk at another place, 
which he did And he took a sample of 
the suspected milk to a chemist, who 
found that it contained quite a large 
amount of formaldehyde, which had been 
evidently used for a preservative. The 
person selling this doctored milk was 
fined, and my poor patient fortunately 



suffered no permanent effects from the 
formaldehyde. 

It is no uncommon thing for the milk 
supply on farms to be so badly tainted 
with barn odors as to be positively dis- 
gusting as food. When I am nursing in 
private families I make it a point to in- 
spect the outbuildings and the sources of 
water and milk supplies, and to inquire 
into the way the milk is cared for and 
handled in transit from producer to con- 
sumer. 

If the patient is a child suffering from 
any intestinal trouble, it is important to 
know what breed of cow produces the 
milk you use, how long she has been in 
milk, and what kind of feed she receives. 

A Durham, Holstein or Hereford cow, 
pasture-fed in Summer, and fed on well- 
cured hay and a little mixed grain in the 
Fall season, and an animal that has not 
been long in milk, produces milk that best 
agrees with sick persons in general, and 
infants and young children suffering 
from intestinal troubles, especially. 

Choose a cow that seems healthy in 
every way ; do not permit the milk to be 
used for invalids from a cow that has 
any lameness, cough, loss of appetite, 
fever, skin eruption or other evidences 
of- illness. 

Generally speaking, tuberculosis and 



306 



THE TRAINED NURSE AND HOSPITAL REVIEW 



garget are the two diseases that most fre- 
quently affect the cow. And early symp- 

m 

toms of these diseases often escape the 
notice of those who care for the animals. 

Pure water in abundance should be 
supplied to the animals, and they should 
be kept in a dean, well ventilated stable 
and allowed plenty of sunlight and exer- 
cise. 

By experiments and chemical tests it 
has been proven that fright or harsh 
treatment of milch cows alters the char- 
acter of milk so as to make it an unde- 
sirable food for children. 

Cows from which milk is procured for 
the sick should not be fed on vegetables, 
hay that contains strong-smelling weeds 
or is mouldy or poorly cured, or on fer- 
menting corncobs or silo feed. And in 
the Fall season, when vegetation is dying 
in the pastures, or is frost bitten, the cow 
from which milk is to be used for the 
sick should be fed in the stable as direct- 
ed above. 

Some years ago I was at a prosperous 
farmer's home, nursing a desperately 
sick case of enterocolitis. I asked about 
the cows they were milking, explained 
about the necessary care, feeding, breed 
of cow, etc., necessary to produce milk 
that would be best for the child. The 
child's grandfather said that there was 
one nice Durham cow in the herd that 
was quite new in milk, and as I asked to 
have the cow stable-fed he did so, and 
also saved the milk separately in utensils 
that I cared for. This cow had never 
been observed specially as to her milk, 
but had been milked into a pail contain- 
ing the milk from several others. 

This may explain why the old gentle- 
man had not noticed the bad condition of 
the milk. When I strained the first milk- 
ing I found both ropy masses and tiny 
blood clots in the milk, and, of course, 



did not use any of it, and planned to 
select my cow myself next time. The 
grandfather said that all he had noticed 
out of the way about the cow was a little 
lameness, but that she ate all right, was 
in good flesh and gave a good mess of 
milk, so he had concluded that she must 
have wrenched her hip in the pasture. 
He seemed unwilling to admit that the 
cow might be diseased in some way. But 
I went to the bam with him to select the 
new cow, and incidentally to look at the 
one that produced the bad milk. Imagine 
my surprise and disgust to find an animal 
that was so lame that she could scarcely 
touch her toes to the floor ; that was not 
in very good flesh and had a number of 
lumpy swellings and areas of infiltration 
in the udder. To make a long story 
short, a veterinarian found the cow to 
be badly affected with garget. 

Now, how people can be so unthinking 
and careless puzzles me; but these are 
fair samples to prove what I said about 
not being able to get as pure milk in the 
country sometimes as can be procured at 
milk stations in the cities. 

Left to his own devices in regard to 
care of milch cows and milk, the average 
farmer will not use the care necessary to 
secure really pure milk. He scoffs at the 
germ theories, and what he is pleased to 
term "cranky, fool notions" in regard to 
cleanliness. 

It would be clear gain to every country 
town to pay a suitable salary to some 
good veterinarian to act as milk inspec- 
tor. It is vain folly to imagine for a 
minute that milkmen in the cities are the 
only ones who adulterate or dilute milk. 

In the country many so-called "cooley 
creamers" are used to set milk in. These 
consist of a large tank to hold the cold 
water in which are submerged the cans 
that hold the milk. These tanks are most 



THE DIET KITCHEN 



307 



often kept in the stable or in a shed at- 
tached to it. In this case the cans are un- 
covered, and the milk strained into them 
there amid unclean surroundings, and it 
not infrequently happens that the cans 
into which the new milk is to be strained 
are left with covers off, waiting (hand- 
ily) for their contents. About four years 
ago I happened into the bam of a man 
who sells cream and milk. Three "cooley- 
creamer" cans stood uncovered in the tie- 
up behind the cows, ready to receive the 
new milk as fast as the pail into which 
he was milking, should be filled. A 
cheese-cloth strainer hung on a rusty nail 
just outside the tie-up, and while I stood 
watching, Mr. Milkman took the strainer 
from its peg and strained the milk into 
the cans; then the strainer-cloth was 
hung again upon the peg, dripping with 
milk, and was soon covered with a swarm 
of hungry flies. Delicious (?) country 
milk, thought I. And I assure you that 
I have never since used any milk coming 
from that place for my patients, or for 
myself either. 

Another source of contamination of 
milk comes from the unclean milk uten- 
sils. These "cooley-creamer" cans often 
receive no washing except a rinsing in 
cold water. It is a wonder to me that 
more persons drinking "country" milk 
don't get poisoned from ptomaines. 



In the Winter time, the cows in the 
average farmer's bam look as if they 
were walking manure-heaps from the 
dried manure clinging to their flanks. 
And if the cow's udder is wet from feces 
or urine, all the cleaning it gets before 
milking is a hasty wiping off with some 
old, dirty bran sack that may be lying 
handily near. 

This accounts in a measure for the dis- 
gusting "bamy" odor and flavor of some 
milk. And in the instances where your 
milkman uses an old, broken wire milk- 
strainer, you will likely find plenty of 
barn-yard debris in the bottom of your 
milk can. 

It is an interesting fact to note that in 
the country one very rarely sees glass 
bottles used for conveying milk to the 
customer. "Too expensive and destmct- 
ible," say the milkmen; so they use tin 
cans, and many of them exchange the 
cans from our customer to another pro- 
miscuously. 

So I say that the city resident has more 
surety of being able to get pure milk 
than his country neighbors, and this 
means invaluable benefit to the sick espe- 
cially. 

It is to be hoped that the country towns 
will soon have a system of milk and cat- 
tle inspection that will assure the con- 
sumers of a pure food. 



To he continued. 



Practical Points 



In giving a patient a seidlitz powder, I 
found that to give it in two doses was much • 
easier for the patient that for him to hurriedly 
drink a whole glassful. 

Have three glasses — put the contents of the 
blue pap^r in one glass, the white in another; 



put a half glass of water to each powder; 
when the powders are dissolved, pour half 
the contents of each glass into the third glass 
and give while effervescing. Then, after 
a few minutes the remainder may be given. 

G. W. A, 



€trttortall^ ^pea&tng 



The Teachins^ of Institutional 
Management 

According to the annual report of the 
Hospital Economics Course at Columbia 
University there were registered for the 
course at the beginning of the school 
year just closed eighteen students. A 
correspondent who noticed the report has 
written asking, "What is the matter with 
the Hospital Economics Course that 
more nurses do not take it?" Hundreds 
of other people have asked the same 
question. If it were the first or seccMid 
year of the course, the showing would 
not be so discouraging, but if we are not 
mistaken the past year was the tenth 
year such a course has been offered. It 
has been advertised and urged and 
boomed at practically every nurses' con- 
vention since the time it began. Nurses 
like to talk about it. It sounds big to be 
interested in "college opportunities for 
nurses." But it is one thing to write 
about it, and discuss it — it is another 
thing to lay down your bread-winning 
occupation and go take the course your- 
self. Most nurses think it is a good thing 
for somebody else, but as for themselvi^s, 
they either do not need it, do not want it, 
or cannot get it. 

That there is a demand for training 
along institutional lines is unquestioned. 
One hospital that offered a practical 
course in institutional management re- 
ceived within the first few months after 
announcing it over a hundred applica- 
tions. There were openings for only 
eight nurses in a year. One might have 
expected the other ninety-two who could 



not be admitted for the course in tlie 
hospital would have gone to the college 
for it. But apparently they did not 

Apart entirdy from the expense cf the 
course at Teachers' College, there is the 
deepening conviction that institutional 
ipai)agement can be better taught in a 
well-organized hospital than anywhere 
else and taught with less expense. In 
defense of the expensive tuition fees at 
Teachers' College it is stated that "the 
maintenance of so large a body of pro- 
fessors and other teachers, of libraries 
and finely equipped laboratories is a 
very costly affair." This is probably true, 
but are those finely equipped laboratories 
and libraries and this large body of pro 
fessors and teachers really necessary to 
teach a nurse to manage a hospital or 
training school ? What of real, practical, 
workable, everyday knowledge can nine- 
ty-five per cent of those professors teach 
a nurse about managing a hospital ? They 
can teach her a great deal, no doubt — ^a 
great deal that will be of little or no 
practical use to her when face to face 
with laundry and kitchen problems ; when 
perplexed with the thousand and one de- 
mands made by the public, the physicians, 
the patients, and the board, in even the 
smallest public hospital. But they cannot 
teach her what can only be learned by 
actual experience with hospital problems. 
In fact, if we may judge by reports of 
those who have had experience with the 
course in hospital economics in Teachers' 
College, there is so much in the course 
along the line of psychology, bacteri- 
ology, laboratory work and social work, 



EDITORIALLY SPEAKING 



309 



and so little that is really practical along 
the line of institutional administration, 
that it is discouraging. This is not saying 
that all these things are not good in them- 
selves. It would be delightful to be able 
to spend one's time in the pursuit of 
knowledge along these lines. But we live 
in a practical working world. We must 
spend our time in acquiring knowledge 
that we can use, and that is the chief 
difficulty with the course at Teachers' 
College, according to the statements of 
nurses who^have entered for the course 
or investigated with a view to entering. 
It is not so much the question of expense, 
but that after a nurse has given up the 
money she> would earn .for the year 
which, to say the least, ought to be six 
hundred dollars — ^and has paid the six 
hundred dollars and more for her ex-' 
penses, making a sacrifice of at least 
$1,200 in a year, she gets so little of what 
she really wants and needs for real, prac- 
tical, executive hospital work; and so 
much instruction from college professors 
on psychology and bacteriology and soci- 
ology and so on — ^things which are "nice 
to know," but which' do not tend to make 
her worth more as an executive in a hos- 
pital. That is, or seems to be, the real 
difficulty with the course at Teachers' 
College. In fact, a great many have said 
that the term "Hospital Economics" was 
a misnomer as applied to the course and 
ought to be abandoned as misleading. A 
great many wise people, nurses, phy- 
sicians and laymen, have affirmed the 
conviction that you "can't leam to run a 
hospital by going to any college" This 
is not saying that the course for nurses 
at Teachers' College ought to be aban- 
doned. The recent endowment makes 
possible the development of splendid op- 
portunities for training along general 



philanthropic and social reform lines, 
and therein is the greatest field for the 
future development of a college course 
for nurses, New York City affords un- 
limited opportunities for actual experi- 
ence in district nursing, tuberculosis 
work and various other lines of work 
to which nurses are more and more 
being called. It ought to be possible for 
a nurse, by doing actual work along 
social welfare lines, to meet a consider- 
able portion of her expenses without in- 
terfering at all with the instruction, in 
theory, which she needs along sociologi- 
cal lines. 

Ten years with experimenting with the 
attempt to teach hospital administration 
in a college ought to be sufficient to con- 
vince those who are not hopelessly fixed 
in their opinions of the futility of such a 
course. "We leam to do by doing." We 
leam also a good deal by working day by 
day with those who are doing actual 
es^ecutive work in a hospital. - And we 
have no hesitation about reaft'irming our 
conviction that the^ best place to kam 
the everyday details of the practical ad- 
ministration of a hospital or hospital 
school is in a well-organized hospital, un- 
der the instruction of and in daily con- 
tact with experienced executives who are 
doing such work. 

+ 

Our Educational Policy 

For years The Trained Nurse has ad- 
vocated in training school work the pol- 
icy of eliminating useless things from the 
nursing course — of teaching fewer les- 
sons, teaching them thoroughly and 
teaching things worth while. 

In doing this we have been in harmcjny 
with the best educators in the general 
educational field, and our policy is that 
which is being applied more and more to 



310 



THE TRAINED NURSE AND HOSPITAL REVIEW 



schools in general. A great many nurse 
teachers who advocate the professedly 
"higher educational ideals" of the ex- 
tremists or radicals in the nursing body 
in practice do not reach anywhere near 
the practical ideals we have advocated. 
For instance, the name of a certain pon- 
derous textbook on anatomy and physi- 
ology for nurses appears in the list of 
textbooks of a large school. Talking with 
the principal of the school not long ago, 
she said, "Yes," they used it, but she did 
not pretend to teach from it. She had 
laboriously gone through it, numbering 
each paragraph, and in a little exercise 
book had made out a list of the para- 
graphs here and there which the nurses 
were to study. For instance, Lesson I., 
Page 13, Paragraph i; Page 16, Para- 
graph 2; Page 27, Paragraph 3, and so 
on. She said she didn't suppose it was 
the best way, but they had the textbooks 
in the school, and though the nurses 
never had been able to cover a tenth of 
the contents of the book, she seemed to 
think that she might be accused of "low- 
ering her ideals" if she discarded it. This 
is just a sample of what is being done in 
order to have the name of belonging to 
the "high idealists party." 

In public schools the policy of concen- 
tration and elimination of non-essentials 
is being adopted everywhere, as any one 
who is interested in and conversant with 
general educational matters knows. Here 
is a sample of the methods that are being 
pursued in a Western city whose plan of 
successful government by commission has 
challenged the attention of students of 
municipal government all over the coun- 
try: 

"Cube roots, compound fractions, par- 
tial payments and other arithmetical 
stunts that strike fear into the heart of 



the schoolboy are to be eliminated from 
the curriculum of the Des Moines public 
schools next year, 

" 'Thoroughness is to be the watch- 
word for us next year,' the superintend- 
ent of the public schools said. 'We will 
make no change in the printed course of 
studies. But we will cut down the sub- 
ject matter taught in each, so that more 
time may be given to oral drilL The 
school children wtU be given fewer things 
to learn, but we will make them learn 
them better.' 

"This revision of the curriculum will 
extend through the high schools, too; 
courses will be changed so that more con- 
centration may be possible. History 
courses will be revised so that the high 
school students may learn fewer things, 
but learn them more surely. In the grade 
schools useless arithmetic problems will 
be left out Certain tables of weights and 
measures have fallen into disuse. The 
wine measure is one of these, and the 
school children of Des Moines will no 
longer be required to learn how to meas- 



ure wmc. 

+ 

Classes in Current Events 

In the outline of the course of instruc- 
ti<Mi for the training school at Morton 
Hospital, Taunton, Mass., there is in- 
cluded a class session every two weeks 
devoted to current topics. In the Cali- 
fornia Hospital, Los Angeles, a similar 
custom has been inaugurated, and we 
earnestly commend the suggestion to 
training schools in general. We are al- 
ways deploring the "shop talk" of nurses, 
the fact that they lose interest in outside 
matters, and clatter away about affairs 
in their own little world — simply and 
solely because they don't know what is 
going on in the big world outside, and are 



EDITORIALLY SPEAKING 



311 



absorbed in the little world of their own. 
A weekly or fortnightly class hour de- 
voted to significant current events 
would be one of the surest ways of get- 
ting at the root of the bad conditions we 
deplore. Such a course need cost the 
hospital nothing but a little effort in or- 
ganizing it. Some of the bright, gifted 
ladies of the board of managers of the 
Woman's Aid Society would be delighted 
to prepare a little study of current 
events. A high school teacher, librarian, 
clergyman, college professor, or bright 
newspaper man or woman could be se- 
cured to assist. Even the president of 
the board, if he is a wideawake man of 
affairs, would be willing to bring to the 
nurses something worth hearing about 
what is going on in the world. 

What is there at present going on 
which might be worth taking up in a 
current events class as a "starter"? Get 
the late number of the Review of Re- 
views, World^s Work, Outlook, and such 
magazines, and you will find enough ma- 
terial for lectures for months. Select the 
topics which seem most interesting, sig- 
nificant and altogether worth while, and 
assign them to some friend outside the 
hospital for study. Get the nurses inter- 
ested in the big outside world. There is 
no surer way to check the aimless, use- 
less chatter about what Mrs. A. said, or 
Mr. B. did, or Miss C. wanted to do, or 
Dr. D. did do, than by giving them some- 
thing else to think about and talk about. 



The Quality and Measure of Zeal 

There is a story told of a certain man 
who had always prided himself on his 
zeal in good works. One night he had a 
dream. He had died and was about to 
be rewarded for his activities while on 
earth. His "score" was being reckoned. 
He saw the angels take his zeal and 
weigh it. It was full weight — a hundred 
per cent, and he was pleased. But to his 
dismay he saw the angels continue this 
investigation of the zeal of which he 
had boasted. They analyzed it — sub- 
mitted it to various tests. His content- 
ment with himself was disturbed when 
he saw that it was made up of 22 parts 
of ambition, 25 parts of selfishness, and 
that pride, financial gain, love of power, 
of personal prestige and various other in- 
gredients made up the greater portion of 
the remainder. "It is good to be zealous- 
ly afFected always in a good thing," but 
there is a zeal that is not according to 
knowledge, which is not backed up by 
common sense, and there is grave danger 
of the zeal being made up of very selfish 
ingredients. 

TTie little story is not without its ap- 
plication in the nursing world, and 
those who are most zealous and at the 
same time determined to secure control 
of something or somebody, may wisely 
be asked to submit their zeal for testing, 
not according to quantity, but according 
to the quality of the ingredients and the 
motives behind this display of energy. 



November 

An' now the Ingin summer time, 'ith all its rest is here, 

A piece of sweetmeat stuck between the slices of the year ; 

A sorter reign er jubilee 'twixt snow an' thunder showers — 

A chunk er sweetness sandwiched in between the frost and flowers. 

Sam Walter Foss. 



Cde ^O0pttal 3aetitetD 



The American Hospital Convention. 

' The convention of the American Hospital 
Association, which was held in St. Louis, Mo., 
in September, was conceded by. those who at- 
tended it to be one of the most enjoyable and 
profitable the association has ever held. The 
attendance was liot as larg^ as it has been far 
the past- three or four years, owing undoubt- 
edly to the fact that hospital work is much 
less developed in the West and Southwest 
than in the Central and Eastern States, partly 
perhaps to the fact that the hospital people 
in the States -adjacent to the convention city 
have not yet felt their .personal responsibility 
for the support and promotion of the national 
association as they should. But what the con- 
vention lacked in numbers was more than 
compensated . for by the- unusual interest and 
value of the sessions, and the delightful spirit 
of cordiality and hpspit^lity which , was so 
marked. 

Never have iht local committee aiid friends 
provided for mdre unostentatious and wholly 
enjoyable social features. . The ^association- is 
under great obligation to Dr. Wayne. Smith, 
superintendent of the Washington University 
Hospital, for his untiring efforts to make the 
StLoiiis convention one of real pleasure as 
well as * profit to all who attended. In his 
efforts he was ably supported by Miss Rogers, 
superintendent of the Jewish Hospital, and its 
medical staff and trustees ; Miss Cfiambers, of 
St. Luke's Hospital,' and fhe faculty of Wash- 
ington University. • 

The social features included a trolley trip 
to the famous Anheuser-Busch brewery, 
where luncheon was served and an auto trip 
which included stops at the Jewish Hospital. 
St. Luke's and the Washington University. At 
the University, Chancellor David F. Houston 
and Mrs. Houston, Professor and Mrs. F. A. 
Hall and Professor and Mrs. F. W. Shipley 
were in the receiving line, and 5 o'clock tea ^ 
was served on the piazzas of the British pa- 
vilion, of World's Fair fame, now the art 
school of the great university. To many of 
the visitors it was a surorise to find in St. 



Louis a university of such size and wealth 
and promise, that it bids fair to stand in a 
few years in the first rank of American Uni- 
versities. 

On the convention programme more promi- 
nence than usual was given to the highly im- 
por^t subject of hospital construction. Dr. 
S.- S. Gold water presented a well-thought-out 
plan foe the construction of ward buildings 
in crowded cities, which is certain to have its 
influence in future building under the condi- 
tions mentioned. Dr. Theodore C; Link and 
Dr. Wayne Smith presented valuable papers, 
illustrated hy stereopticon views, dealing with 
hospital construction in St. Louis, a subject 
of tremendous importance in that city at the 
present time. The report of Mr. H. E. Web- 
ster,' superintendent* of Royal ViAoria Hos- 
pital, Montreal, was one of the most compre- 
hensive and interesting of all the reports on 
the general subject of hospital construction 
which* have been presented. 

The' greater part of one morning session 
was given to the relation, that exists, or should 
exist, between the hospital and charity organ- 
izations. Mr. W. H. McClain, manager of 
St. Louis Provident Association, and Mr. Bai- 
ley B.' Burritt, secretary of the State Chari- 
ties Aid Association of New York City, ably 
represented the Charity Organization interests. 
Mr. Clarence Williams, president of the 
Board of the New England Deaconess Hos- 
pital; Boston, who is a specialist in hospital 
heating and ventilation, discussed the import- 
ant, but rather dry, subjects of hospital heat- 
ing and ventilation in a most interesting man- 
ner and in terms which did not require expert 
knowledge to understand. He held the atten- 
tion of his audience from start to finish and 
seemed thoroughly at ease in replying to the 
rapid fire of questions which followed his 
paper. 

One of the most important papers of the 
convention was the one on "The Training of 
Hospital Superintendents and Heads of De- 
partments," by Dr. F. A. Washburn, superin- 
tendent of Massachusetts , General Hospital, 



k 



THE .HOSPITAL REVIEW . 



13 



Boston. His subject is one to which more and 
more consideration is certain to be given by the 
association in years to come. Dr. Washburn 
and Dr. Babcock, in establishing practical 
courses for the training of superintendents 
and heads of departments and showing how 
such courses may be given by large hospitals 
at very small cost to the pupil and to the 
hospital, ace blazing a way which i^ certain to 
lead to greater efficiency in the hospitals of 
the future. 

The subject of hospital accidents was ably 
dealt with by Miss Minnie Goodnow, superin- 
tendent of Bronson Hospital, Kalainazoo, who 
had been . assisted in the preparation of her 
paper by Attorney Frank T. Lodge, of 
Detroit Few papers that have ever been pre- 
sented before the association have been re- 
ceived with more sincere appredaton and com- 
mendation than Miss Goodnow's. 

The round table conference for superin- 
tendents of small hospitals provided the op> 
portunity for brief discussion of a variety of 
practical subjects for which the women super- 
intendents and representatives of the smaller 
hospitals have long wished. It is earnestly 
hoped that these round-table discussions may 
be made a part of each convention in the 
future. The following subjects were brought 
up for consideration and discussion, and for 
over two hours, without any formal written 
papers, free interchange of thought and expe- 
rience prevailed; 

General Administration. 

1. The Desirability of Having Both Regular 
and Homeopathic Physicians on the Medical 
Staff of the Hospitals in Smdllef Cities and 
Towns. 

2. How Best to Arrange for Open- Air Treat- 
ment in Small Hospitals. 

3. Can a Small Hospital be so Arranged as 
to be Sdf-Supportng or Nearly So? 

4. How to Avoid Loss by Non-Payment of 
Billk. 

5. Is It Possible to Arrange a Satisfactory 
System for a Department of Electro-Therapy 
and for X-Ray Work Without a Paid Special- 
ist in Charge? 

6. What Paid Workers and How Many Are 
Necessary in a Hospital of Thirty, to Sixty 

Beds? 

7. Should a Small Hospital Attempt to Keep 
Qinical Histories Beyond the Ordinary Nurs- 
ing Records? If So, How Is It Best to Manage 



I his Work Where Ko Interne Is Emplpyed? 
. 8. Is a Medical btaff a Vital Necessity to the 
S)n£^U Hospital? . Does a Stallt H.elp or Hinder 
the Progress of. Such a Hospital? 

Training School. 

1. How Best to Arrange for Instruction in 
Dietetics and Massage in Isolated Small Hos- 
pitals. ... 

2. Divide Nursing Responsibility Versus In- 
dividual Responsibility- in the Daily Care of 
Patients. . . 

3. How Much Teaching Should the Super- 
intendent of a Small Hospital Be Expected to 
Do? . 

4. Bad Class Work — Teacher or Pupil — and 
How to Guard Against It. 

5. How to Increase the Supply of Desirable 
Probationers in Small Hospitals. 

6. How Can We Better Prepare Our Nurses 
for Private Duty. 

Domestic. 

1. What Sum Is Considered an Adequate 
Wage for the Head Latmdress of a Fifty-bed 
Hospital? 

2. How Best to Handle the Laundry so as 
to Prevent or Diminish Waste and Loss of 
Linen and to Keep Account of the Loss in a 
Small Hosjpital. 

3. Should the Matron of a Small Hospital 
be Required to Take the Entire Charge of the 
Daily Cleaning of the Hospital, Preparation 
of Rooms for Patients, Etc? What Respon- 
sibility Does She Usually Have Regarding the 
Serving of Meals and Removal of Trays? 

4. Which Is the Most Needed in the Average 
Small Hospital — a Housekeeper or a Dietitian? 

5. How Can the Supply of Competent 
Housekeepers be Increased? 

Miss Emma A. Anderson, of the N. E. 
Baptist Hospital, Boston, and Miss C. A. 
Aikens, of Detroit, led the discussions. 

The exhibit of non-commercial appliances 
invented, improved or arranged by hospital 
workers was one of the very attractive and 
useful features of the convention. As only 
seven weeks had elapsed from the time the 
president decided to attempt something in the 
line of an exhibit as a start for the exhibit 
idea, it was not possible for many who de- 
sired to contribute to arrange to do so. But 
the exhibit was voted by everybody a splen- 
did success. ' A vote of thanks was tendered 
Miss Aikens for her efforts in arranging for 
it and to the contributors who made it pos- 



314 



THE TRAINED NURSE AND HOSPITAL REVIEW 



sible. It was unanimously decided that an 
exhibit along similar lines should be provided 
for next year. Elsewhere in this issue a de- 
scription of the exhibits will be found. 

The report of the committee on the nursing 
of people of limited means was presented by 
Dr. Young, assistant superintendent of the 
Presbyterian Hospital, New York. A digest 
of the report will be presented in a future 
issue of this magazine. 

Dr. W. L. Babcock, superintendent of 
Grace Hospital, Detroit, was elected president, 
and Dr. J. N. £. Brown, of Toronto, secretary 
of the association. Both of these gentlemen 
are well-deserving of any honor the American 
Hospital Association can bestow. Dr. Bab- 
cock's efforts during his three years as secre- 
tary have been largely instrumental for the 
splendid growth of the association during that 
time. Presidents have come and gone. He 
has patiently carried the increasing burden 
that falls to the secretary, and discharged 
the duties in a manner that has commanded 
the confidence of the entire American Hospital 
world. In its treasurer, also the association 
has great reason for gratitude, and the elec- 
tion of Mr. Asa Bacon, of the Presbyterian 
Hospital, Chicago, for the fourth term to that 
important office is a tribute to his quiet, faith- 
ful labor for the association. 

Next year the convention meets in New 
York. Everybody expects it to be the biggest 
and best we have ever had. Dr. Howard, of 
Boston, made an able president, and without 
question much of the success of the splendid 
sessions of this year was due to his careful 
planning and competent leadership. New York 
City, the great hospital centre of America, 
has much to offer as attractions for hospital 
workers apart from the splendid programme 
of practical things that is sure to be provided. 
All who are interested in hospital work will 
do well to begin now to make their plans to 
attend. 

+ 
Tho Women's Aid AMOclatlon. 

The Woman's Aid Associations of hospitals 
have it in their power to help hospitals in 
innumerable small ways which will greatly 
increase the general efficiency, if — and the "if" 
here is very large — there be at the head of 
that association or identified with it one or 
more women who have what is termed 
initiative. Executive ability may be defined 
a.« the ability to plan work for other people 



to do, and to get them to do it. This is a 
quality which every hospital superintendent 
has — ^must have — to a greater or less extent, 
and her executive ability may well be applied 
to the work of the Women's Aid Associatioa 

The report of the Hale Hospital Women's 
Aid Association shows that it has assumed a 
large part of the salary for a diet kitchen in- 
structor, that it is paying lor having all the 
mattresses needing it to be remade, shared the 
cost of the telephone, sent fruit and ice 
cream for holiday occasions, contributed money 
for the superintendent to buy presents for the 
Christmas tree, besides contributing quantities 
of sheets, pillow covers, gowns, bath robes 
and such necessaries. There is every reason 
to believe that small hospitals that wish to im- 
prove their training by employing paid in- 
structors for massage and dietetics could per- 
suade the Women's Aid Associations to 
assume the cost of these instructors, in many 
cases, if the superintendent led the way and 
presented the needs squarely before them. 

Needed culinary appliances could be secured 
from the same source that would make the 
trays much more attractive. Individual bak- 
ing dishes, custard cups, aluminum covers for 
covering food on trays during transit from 
kitchen to patient, little covered soup bowls, in- 
dividual moulds for lemon jelly and all such 
useful little appliances that make for refine- 
ment and better satisfaction in hospital food 
serving could be had for the asking, in most 
cases. The local dealers, perhaps, do not have 
all these things in stock, but they can be 
secured from dealers in institutional supplies 
in large cities. 

Small ice-cutting machines for each floor 
that will obviate the necessity of nurses waking 
patients with the pounding of ice in the night 
would serve a useful purpose and could be 
had. Small ice cream freezers that would 
make it easy for the nurse on special duty to 
prepare special delicacies for her own patient 
would make it much easier to please fastidious 
patients, or those not so fastidious. General 
efRciency demands things to work with and 
wherever possible to make work easier, and in 
working toward a higher degree of efficiency, 
the Women's Aid Associations can become 
potent factors. Whether they always are or 
not is another question. They can hardly be 
blamed for inactivity or for not accomplishing 
much if the superintendent does not make her 
special needs and desires known. 



THE HOSPITAL REVIEW 



315 



N«w York Polyclinio HotpiUI. 

The New York Polyclinic is to have a new 
building to cost $5oo»ooo. Plans have been 
drawn for an eleven-story building with base- 
ment and sub-basement. The new building 
will be on Fiftieth street, near Ninth avenue. 

The laundry, drug and store rooms will 
be in the basement and sub-basement The 
iirst floor will contain a room for the visiting 
staff of doctors, the superintendent's room, 
visitors' waiting room, students' room, private 
patients' reception room, a large hall with sta- 
tionary seats for waiting patients and a large 
room for the trustees of the hospital. On 
the second story will be the medical amphi- 
theatre, four wards, examination rooms. X-ray 
room and skin laboratory; the third floor will 
be given over to the surgical amphitheatre, 
minor surgical operating room, four wards and 
a number of recovery rooms. 

The mezzanine floor will contain rooms for 
the treatment of the ear, nose, throat and eye ; 
the children's ward, maternity ward and 
museum will occupy the fourth floor; the fifth 
floor will contain sleeping rooms for the 
nurses and servants' dormitories; from the 
sixth to the eighth floor inclusive will be the 
private rooms; the ninth floor will have pri- 
vate operating rooms and wards; the tenth 
floor will be given over to the isolation wards, 
officers', nurses' and servants' dining rooms, 
and on the eleventh floor will be separate sola- 
riums for private patients, ward patients and 
for the children. 

+ 

Naval Hoepltal at Norfolk. 

The new wings to the Naval Hospital at Nor- 
folk, Va., are now completed, and the building 
is said to be about the finest hospital the 
United States Government has. 

Two large wings have been added, one on 
each side of the original portico, and the 
hospital now has twelve wards of twenty- 
eight beds each, each ward equipped with 
two quiet rooms and diet kitchen. Its operat- 
ing pavilion in the dome of the building con- 
sists of a main operating room, sterilizing 
room, wash room, anesthetic room, toilet and 
shower and needle bath rooms. There is 
nothing more modern in equipment or elabor- 
ate in all that pertains thereto, and marked 
simplicity of plan combines with a strikingly 
imposing appearance. 

The installation of electric fixtures in the 



new wings has occasioned considerable delay 
in the occupation of these additions. 

Each ward will be presided over by a gradu- 
ate female nurse, all of whom are under the 
direction of a chief nurse, and in addition 
the hospital has a corps of sixty male nurses. 
The furniture provided for each patient is a 
bed, clothes press, chair and writing table. 
Each ward is equipped with washroom, bath- 
room, linen room, toilet, and a clothes chute 
leading to the laundry in the basement. Tele- 
phones in each ward connect with the office of 
the doctor hi charge. 

The hospital cares for all the sick of the 
naval station, including the receiving ships, 
training station and the marine barracks. A 
great deal of surgical work is done, there 
being from six to eight major operations a 
week, most of them for hernia and appendi- 
citis. Prevalence of the latter class of cases 
amounts almost to an epidemic. 

+ 
Notes and News. 

The Syracuse Hospital for Women and 
Children enters on a new era of usefulness 
with the opening of its new laboratory, which 
is said to be equiped for general research 
work. The work of the laboratory will be un- 
der the direction of Halbert W. Steensland, 
chief of the Bacterological Department of 
Syracuse University, and Dr. William A. 
Groat, of the Department of Chemistry. It is 
believed that the laboratory course to be given 
may be of great benefit in fitting men for 
municipal positions. Dr. Simon Flexner has 
named this hospital as the local depository for 
his anti-meningitis serum, so that physicians 
desiring it may be able to secure it without 
delay. 



The Sisters of Mercy have purchased prop- 
erty in Omaha and are fitting it up as a hos- 
pital for women. 



H. M. Kurtz has presented $5,000 to the 
Clearfield (Pa.) Hospital to erect a nurses' 
home. Mr. Kurtz was a former patient in the 
hospital. 



A Pittsburg dispatch states that owners of 
office buildings with 1,000 or more office occu- 
pants will equip a small emergency hospital 
in the building and have a trained nurse in 
charge. In the Oliver Building, owned by 



316 



THE TRAINED NURSE AND HOSPITAL REVIEW 



United States Senator Oliver, the emergency 
hospital is already in operation. 



A vigorous campaign among the Lutherans 
of Brooklyn and Manhattan is to be begun to 
secure ^isojooo for a new hospital to be lo- 
cated in Brownsville. 



The Methodists of Peoria, 111., will build 

a new $50,000 hospital to replace the present 

structure. 

* ... 

The Philadelphia Jewish Sanatorium for 

Consumptives has completed plans for a chil- 
dren's pavilion at the farm in Eagleville, Pa. 
It is aimed to secure a considerable portion 
of the funds needed by the sale of a stamp, 
known as the Hebrew New Year Stamp. 
These little stickers are modelled after the 
familiar Red Cross Christmas Stamp. The 
Jews, it is said, are in the habit of exchanging 
cards with each other about the Fall holiday 
season, and they will be asked to affix the 
stamp this year for that purpose. 



A roof garden for the care and treatment 
of ailing babies has been in operation the past 
Summer at Flower Hospital, New York. 



The homeopathic physicians of Des Moines 
have begun a campaign for the raising of 
$100,000 for hospital buildings. The present 
plan h^ to build the children's building first 
and later on to add other wings. 



A Masonic Hospital at Louisville, Ky., to 
cost $300,000 is being planned. 



A county hospital, to cost in the neighbor- 
hood of $100,000, is to be built by Salt Lake 
County. 



A training school was opened in Septem- 
ber in connection with the Helena (Ark.) 
Hospital. During ihe-irst year 109 patients 
were treated. 

Mr. Henry M. Faxon is to present the 
Quiiicy City Hospital (Massachusetts) with 
a nurses' home, to cost approximately 
$15,000. 



A campaign for the establishment of a 
Pasteur institute or hospital in Indianapolis 
has been started. Dr. Wegner is the moving 
spirit and his proposition is to build the insti- 



tute out of a fund to be 'established- in the 
levying of an additional dog- tax. The heads 
of forty- four dogs found to have had rabies 
have been examined at the laboratory of the 
State Board, and thirty-one persons have been 
bitten by the afflicted animals. 



Extensive additions and improvements are 
being made to the Pittston (Pa.) Hospital. 
Plans for the accommodation of a larger num- 
ber of private patients are being developed as 
rapidly as possible. Miss Cumming is the 
efficient superintendent, and under her manage- 
ment the institution has greatly prospered. 



An emergency hospital has been established 
at Biloxi, Miss., with Miss Armstrong, a 
graduate nurse, in charge. 



The new $70,000 Eastman Building of the 
Hahnemann Hospital, Rochester, N. Y., will 
be opened this Fall. 



The directors of the new Mercy Hospital, 
Altoona, Pa., have adopted the following 
schedule of rates : Wards, $7 per week ; semi- 
private rooms, two beds, $10 per week; strictly 
private rooms, $15 per week. Miss Virginia 
Walker is in charge, with Miss Rose Scham- 
palas assistant. 



A hospital to be known as the Rockingham 
Memorial Hospital, to cost $30,000, will be 
built at Harrisonburg, Va. 



Kalispell, Montana, is to have a $40,000 
hospital, operated by the Sisters of Mercy. 



The Sisters of the Incarnate Word will erect 
a $75,000 hospital at San Angelo, Texas. 



The General Hospital, of Devil's Lake, has 
been incorporated. 



Edward M- Sparrow, of Lansing; Mich., 
has made a gift of $100,000 to that city to 
be Used to erect a hospital. 



The Anderson County Hospital, S. C« is 
now ready for occupancy. It cost $40^ooa 



The Harry T. Howard Hospital is to be 
erected at Meridan, Miss., by the man whose 
name it bears. • ' 



3fn He Crammg 



CONDUCTED BY CHARLOTTE A. AIKENS. 




Teaching Bacteriology in the Training School* 

MASY E. SEID. 



In the past three years methods of teaching 
almost all subjects in our training school 
course have undergone changes, and I doubt 
not that methods of teaching the principles of 
bacteriology to nurses have also changed. Pos- 
sibly, I may not have kept up with all these 
changes. Naturally, therefore, there must be 
many of you here present who could prepare 
and present a much better paper on this sub- 
ject than can I, since you are all in active 
service, either in the training school or in 
private practice. While I have striven to be 
"up to date" in this most interesting and im- 
portant branch of science, both as regards 
keeping in touch with new discoveries and 
new theories, as well as with what the best 
thinkers and writers along bacteriological 
lines consider the essential points to be taught, 
I have not concerned myself quite so much 
about new methods of presenting these 
essentials, but have left that to those of you 
who are still filling posts of duty in the train- 
ing school. 

I find, however, that many of our best teach- 
ers of the present day are still dividing the 
work of teaching bacteriology into three 
distinct sections: 

First. 

Practical Teaching on the Floors, by the 
Superintendent of Nurses or the Head 
Nurse— covering dangers to be guarded against 
in every department of the hospital where bac- 
teria may enter and gain a foothold. This 
teaching to begin when you receive within your 
doors a probationer and to end only, so far 
as you are concerned, when you bid her adieu 
at the end of her training school days, should 
you later on accept her as a pupil and should 
she finish the course. 

Second. 

Theoretical Teaching, from text books in 
class, supplemented by Lectures— your class 

nteeA at the Fifth Annual Meeting of the West Vlrgrinla State Graduate Nurses' Aflsooiati<m 
at Charleston. Oontrlhuted to Th« TaxiNBD Nuebi. 



work to broaden practical every-day teaching — 
and covering: 

History of Bacteria; Relation of Bacteria to 
Disease; Bacteria in Processes of Nature; 
Division of Bacteria into Classes, and De- 
scription of the Most Important Pathogenic 
Bacteria; Methods Whereby Bacteria Multi- 
ply; Invasion of Bacteria into the Httman 
System; Dangers to be Guarded Against; De- 
scription of Saprophytic Bacteria (the friendly 
germs), and the Benefits to be Derived from 
These by the Human Family; Common Com- 
municable Diseases; Their Cause and Method 
of Dissemination; Immunity and Its Divisions; 
Serum Therapy; How Serums are Procured 
and How and When Used; Theoriefe of 
Ehrlich, of Metchnikoff and of Wright; Bac- 
teria in the Surgical World, including Sepsis 
and Its Causes; Asepsis and Antisepis; the 
Operating Room, Disinfection, Disinfectants, 
Fumigation, Solutions, Their Preparations and 
Uses, and so forth; The Nurses' Duties With 
Regard to Personal Hygienic Precautions 
Against Bacterial Invasion, this lesson to in- 
due Why Nurses Should Not Wear Uniform 
on the Street; Dangers Arising from Failure 
to Obey This Injunction; Explain When and 
Why Uniforms Were Devised ; Value of Sun- 
shine and Fresh Air as "First Aids" Against 
Bacterial Invasion as Well as Their Value as 
Disinfecting Agents; Explain Also the Value 
of Sunshine and Purity of Soul in Apposition 
to the Germs of Evil of Various Kinds Which 
Try to Gain an ESntrance Into Our Lives and 
So Destroy Their Usefulness. 

The lectures by the bacteriologist on the 
staff to enlarge upon and emphasize your class 
work. 

Third. 

Laboratory work under a good, sensible, en- 
thusiastic pathologist or bacteriologist, if you 
are so fortunate as to have one on your staflF, 



318 



THE TRAINED NURSE AND HOSPITAL REVIEW 



or in charge of your labororatory. This work 
to cover: 

(i) Care and use of the microscope. 

(2) Microscopic observation and examina- 
tion of bacteria found in specimens of water 
taken from different sources of water supply, 
before and after sterilization. 

(3) Observation and examination of bac- 
teria found in milk. Specimens to be gathered 
from different dairies and from the hospital 
supply. 

(4) Observation and examination of the bac- 
teria, etc., found in dust from sweepings of hos- 
pital wards and rooms; from private home 
sweepings, and dust from the street. 

(5) Examination of hand cultures, cultures 
from rubber gloves, both before and after 
sterilization. 

(6) Examination of cultures from gauze 
dressings and sutures and suture material. 

(7) Cleansing and sterilizing tubes and 
other glassware used in laboratory work. 
Proper method of making cotton plugs and 
plugging test tubes. 

(8) Making of culture media. Technique 
of media inoculation. Plate preparation. 
Hanging drop preparation. Making prepara- 
tions for staining bacteria — and their micro- 
scopical examination. 

(9) Microscopic observation of bacilli — 
Spore-forming species, bacillus typhosus, bacil- 
lus tuberculosis, bacillus diphtheriae. 

(10) Preparation and demonstration of a 
Widal test. 

(11) Observation of micrococci, staphylo- 
cocci, streptocci, pneumocci, gonococci. 

(12) Observation of spirilla, spirilla of 
cholera, spirocheta palliada of syphillis. 

These lessons to be subdivided, if necessary, 
and rearranged to suit your own particular 
class of nurses. Length of time to be devoted 
to each lesson, such as your judgment dictates. 

You will agree with me, I feel sure, that the 
practical teaching should be presented as 
simply and as clearly as possible, yet at the 
same time it should cover the ground very 
thoroughly. The same rule holds good in our 
class work and in the laboratory. 

In our everyday teaching on the floors, in 
the wards, at the bedside, and in every de- 
partment throughout the hospital we must im- 
press upon these young women that the study 
of bacteriology is a necessity at every step 



of the way from the time they enter the hos- 
pital as probationers until the> pass out again 
as full fledged nurses, and then away into the 
years beyond. To quote a statement of the 
patron saint of the nursing world, in Europe 
and America, Florence Nightingale, "the angd 
of the battlefield," "We must be students of 
this and every other branch of nursing 
always. It is a lifetime work and we never 
can know too much. This grand woman was a 
student until the day of her death— a few 
weeks ago, aged ninety years — even though 
she was, much of the time, an invalid, and 
for a number of years was confined to her 
bed 

More than ever was I impressed with this 
study thought a month or two ago, while 
listening to an address given by one of our 
city physicians to a graduating class of nurses : 
"Young ladies," he said, "do not think you 
Icnow it air because you have received your 
diplomas to-day. Keep on studying. What is 
good practice to-day may be obsolete five years 
hence." How true this isl 

We must realize the importance of the 
study of bacteriology more and more, when 
we take into consideration that disease germs 
are about us everywhere; in the air we 
breathe; in the earth we tread beneath our 
feet; in the dust that floats in at our carefully 
screened windows and doors — ^when we know 
that a stray fly carries in thousands of germs 
attached to its hairy feet; that mosquitos, rats 
and mice and other household pests carry 
disease germs, and that even our pet cat or 
dog may bring them to us embedded in their 
coats of hair or fur— that disease germs in the 
air settle on the hands and faces and lurk 
beneath the finger nails of even the most 
cleanly. 

Even before a probationer gets around to 
being a pupil nurse she has power to do in- 
finite harm in her every-day duties in proba- 
tionary capacity, because of her lack of knowl- 
edge on these very points. Therefore, take it 
for granted that she knows nothing and that 
she must be instructed, and begin your in- 
structions at once. If she is never accepted as 
a pupil of your training school, the knowledge 
she has gained will not overburden her. 

When you at first try to unfold the prin- 
ciples of bacteriology in your class work, do 
not forget that your pupil nurses ar« only 



IN THE TRAINING SCHOOL 



319 



beginners. I shall always remember how dense 
the subject seemed to me in uie early days of 
my training-school career, when there were no 
text books on bacteriology to be had and when 
onr hospital superintendent and the lectures on 
this subject "talked over our heads." How 
we frowned over the notes we had attempted 
to gather and found them "worse than Greek" 
so far as our understanding them was con- 
cerned. Later on, what a boon it was when 
the Superintendent of Nurses came to the 
rescue and attended lectures with us. She 
smoothed out many of our difficulties by more 
than once blandly reminding the lecturer that 
we were "merely pupil nurses, and not fourth- 
year medical students." In after years, when 
T was privileged to take up this study again 
in post-graduate work, what a relief to sit un- 
der instruction of professors who made things 
so plain that he who ran might read and 
thereafter become enthusiastic students of the 
subject These men are themselves enthus- 
iasts, and whether the lecture was along histori- 
cal lines and we were introduced to the old 
fellows who first discovered bacteria, or 
whether in laboratory demonstration or oper- 
ating room technique, or in maternity work, or 
surgical nursing problems, we never for an in- 
stant lost interest. When we took our first 
lesson in the use of the microscope and learned 
of Leeuwoenhoek, of Holland, and his work, 
away back in the 17th century, we were fairly 
made to see the old Dutch microscopist peer- 
ing into unknown mysteries; then on to the 
year 1846-07 to the time of Semmelweis, of 
Hungary, and we in imagination watched him 
pace the maternity wards of that old, old 
general hospital in Vienna seeking to discover 
the cause of the existing awful mortality that 
wrung his very soul. In imagination we wit- 
nessed his enthusiasm when he had traced 
the trouble to the infection carried in on the 
hands of the medical students, who, after dis- 
secting room work, came straightway to assist 
at births in these wards, often without thor- 
oughly washed hands. We fancied his delight 
when through his efforts this cause no longer 
existed and the enormous death rate became 
a thing of the past; then how almost sad we 
became at the story of his death in an insane 
hospital, his malady due to grief over the 
cold Teception the skeptical gave to his won- 
derful discovery — one of the most wonderful 



ever proclaimed, before or since, namely, the 
cause of puerperal sepsis — a discovery for 
which every mother in the world, from that 
time up to the present day, has had reason to 
thank God. 

And so we were led through the years, and 
on up to 1862, to the work of Louis Pasteur, 
of France, and, later, to the investigations of 
Robert Koch, of Germany, these men the real 
interpreters of bacteriological science as we 
are studying it to-day. I'hen followed the 
story of Lord Lister, of England, the "father 
of antispetic surgery," through whose discov- 
ery, in 1875, sepsis lost its power. 

Dangers from these unseen foes to life and 
health were made so clear to us, by object 
lessons, by illustrations, by practical work, by 
laboratory demonstrations, by bedside talks, by 
precept, by example, that it almost became 
second nature to look out for and never give 
quarter to these mischievous children of the 
plant kingdom. 

When, later on, I became a teacher in train- 
ing schools, with the exception of a chapter 
here and there in text-books on otiher sub- 
jects, we still had no text-book teaching on 
bacteriology for nurses (except in the last few 
years I taught, when I used my own compila- 
tion) and teaching the subject presented 
difficulties unknown to-day. In order to 
arrange lessons for class work one had to wade 
through "impossible" matter in text books 
written for physicians and medical students. 
It meant a great waste of time, to say the 
least, to go through so much material and 
cull therefrom and simplify for class work 
the lessons necessary for an intelligent, sane 
and sensible interpretation of the study. No 
easy task, either, as I am sure any of you 
who have been through the same difficulties, 
in by-gone years, must concede. 

The work of supplementing class work by 
lectures on the subject by a member of the 
staff presented the same difficulties as in my 
own experience in early training-school days. 
It seemed difficult to find some one who 
knew just what to teach and what to omit, 
or to in the least simplify his language. After 
lecture the cry arose on all sides, "Dr. So 
and So's lecture was so filled with big words 
that we could not make head or tail of it, and 
won't you please explain?" Yet these men 
were always so good about trying to use 



320 



THE TRAINED NURSE AND HOSPITAL REVIEW 



simple language when their attention was called 
to the nurses' difficulties ! 

The whole matter of teaching bacteriology to 
nurses seems to resolve itself into just this: 
Be alive to its necessity and be enthusiastic 
over the subject yourselves — then will you 
strive to make the lessons so simple and so 
instructive and so interesting that your pupils 
must of necessity become enthusiastic, too. 

Every teacher of bacteriology, and every 
lecturer on this subject, as well as every other 
subject taught in our training schools, should 
themselves be students, and diligent students. 
Understand every inch of the ground you wish 
to cover in the lesson you attempt to teach. 
Sift it to the bottom Encourage your pupils 
to ask you questions, and be prepared to answer 
them. In no other way can they gain a clearer 
view of what you wish to impress upon them. 
One plan that has appealed to me in class 
work is that of reading over the text-book 
lessen with the pupils as part of the class exer- 
cise. Explain any difficult points as you go 
along and then ask for questions on anything 
not quite clear. After this closed books, and 
a memory test, this test to consist of a short 
paper, written there in your presence, covering 
briefly, and in their own words, what you have 
gone over and what they consider the most 
important points to be remembered. Collect 
the papers at the close of class, and take the 
trouble to read and correct them, and give 
them back to your pupils before you take 
up the next lesson. There is no better way to 
discover how much knowledge of what you 
have attempted to teach each has gained. Maps 
or charts illustrating the different forms of 
pathogenic bacteria are very valuable aids in 
class work. 

Do not fail to attend the doctors' lectures 
with your nurses, if at all possible. 

Lastly (and I am sure you are all glad), 
laboratory Work. Unless you are an expert 
do not attempt the laboratory demonstrations 
(except the very simplest ones). Leave these 
to the pathologist or bacteriologist in charge 
of your laboratory. 

If you have no laboratory, or its equipment 
is incomplete, these lessons should be taken up 
in some good hospital (containing proper 
equipment) with which it may be possible for 
your school to affiliate; or, the teaching under 
a bacteriologist may be taken up as post- 



graduate work later on. Practical work, class 
teaching and the lecture course should go hand 
in hand, as a rule, but it is the concensus of 
opinion among the best teachers of the present 
day that the difficult laboratory work should 
be optional, not compulsory 

Go to the laboratory lessons with your class, 
as there is danger of their getting into too 
"deep water" there, also. 

The simple exercises, such as examining 
under the microscope, dust and sweepings from 
rooms, nail scrapings, observation and ex- 
amination of the various forms of bacteria 
and their sub-divisions, etc., are interesting and 
profitable to demonstrate yourselves. 

One very interesting demonstration is the 
examination under the microscope of the com- 
mon house fly. I do not know that any of 
you have had pupil nurses who, in spite of all 
rules to the contrary, would either take out 
window screens, or else push the window sash 
up several inches beyond the screen, if you 
have not screens over the entire window. 
Have a nurse catch just one fly that this act of 
thoughtlessness has let into your hospital ward, 
or room, and have the class examine it mic- 
roscopically. What they discover ought to be 
an object lesson they will never forget. Turn 
the fly over on its back, and see what kind of 
feet it has. Each foot has an equipment of 
claws and pads, two pairs on each foot. Flies 
cling to rough surfaces by these pads, and to 
smooth surfaces by a combined action of both 
pads and claws. The pads are covered with 
thousands of tiny, sticky hairs to which every- 
thing adheres. From the time he ceases to 
be a grub the fly is hampered with sticky feet. 
He loves garbage piles and dirt heaps and all 
sorts of refuse which he finds about the 
premises of the uncleanly, and straight from 
these he comes in through the aperture be- 
tween screen and sash. He has gathered up 
millions of disease germs from these unclean 
places on the thousands of hairs on his feet 
and he deposits them wheresoever he will. 
Watch him try to shake off this deadly load. 
If he cannot rub or shake it off he washes 
it off with his tongue, just as a cat washes 
her paws. This he swallows and, loaded to 
the utmost with a multitude of germs, it passes 
off as excreta. The ordinary house fly has 
come to be called "the typhoid fly." When 
the nurse learns this fact and imparts her 



IN THE TRAINING SCHOOL 



321 



knowledge to the laity let us hope that eacn 
may profit by the lessons. Flies swal- 
low typhoid bacilli in countless mil- 
lionSf while feeding on excreta and throw 
them off again in their own excreta 
in untold greater numbers than those 
they shake or rub from off their feet. They 
alight on food in your diet kitchen and deposit 
excreta there, or on the milk pitcher if you, 
indeed, manage to keep it out of the milk itself. 
Just think of this one thing alone 1 

Have you ever had pupil nurses take off 
their shoes, laden with dust and clay from 
the street and deposit them on their clean 
white beds» or place them on the mantle piece? 
One can scarcely credit such offenses as these, 
yet I can vouch for just such experiences, and 
many even more offensive, not only with pupil 
nurses, but — ^must I tell it — with graduate 
nurses, also. The time to begin to train this 
sort of Woman is away back with her grand- 
mother. Have a nurse scrape a speck of clay 



from the heel of one of these shoes and have 
the class examine it microscopically. Surely 
they will learn from the lesson that street 
shoes, or any other shoes they have worn, are 
dangerous as well as unsightly and question- 
able mantlepiece or bed ornaments. Let them 
also glean from an examination of a little dust 
from the sweepings of the ward, or any 
other sweepings why it is that we continually 
din in their ears, "Dust and dirt mean danger." 
When the pupil nurse accepts, through your 
teaching, the importance of these and other 
essentials, which she sometimes seems to think 
too trivial for consideration, the pathway of 
the Superintendent of Nurses and the Head 
Nurse will be smoother I will not say ''then 
will your nights be filled with music," because 
sounds heard at night in hospital work are 
not apt to be musical; but I will say that 
many of "the cares that infest the day will 
fold their tents like the Arabs and as silently 
steal away" 



Florence Nightingale in Memoriam 



Great pillar of light and love! 
Torch-bearer of our Art, 
Who hath nobly pointed us the wayl 
After thy glorious span of ninety years 
Thou hast been called from out our midst 



iJ w.liL»l;..«.ir_iJ J..! 



U ..u- J J 



Jjj 



Thy name has long since 

Become a fireside legend 

In every land that England owns. 

And thy work has permeated 

The entire earth from pole to pole. 

Kings and Emperors, Queens and Princes 
Have each one paid thee homage. 
The Victorian Cross and merit orders. 
Great favors of royal love, 
Upon thee have been conferred. 



And other. gifts most precious 1 

But the gift which thou has valued most. 

While yet the humblest of them all. 

Is the eternal and loving gratitude 

Of great and small of all the human race. 

Thou hast followed the gallant soldier. 
From thy peaceful fireside, 
To the battlefield and distant camp fire — 
Full well did England style thee 
"The Angel of the Crimea." 

Thou hast walked into the fever camp. 
And with thy great shield of loving care. 
Thou hast lifted the pall of darkness 
From o'er the cot, and health and strength 

returned. 
Though ever the dread sword of death hung 

near. 



And to-day, as the whole world moms for 

thee. 
Let us hope that thy followers. 
In every clime, will turn in spirit 
To offer up our solemn tribute 
Of silent prayer, for thee in death. 

Winifred A. O'Hagan, 



iSooi^ 3Elet)tetDS( 



Primer of Sanitation. By John W. Ritchie, 
Professor Biology, College of William and 
Mary, Virginia. Illustrated, cloth, 40c. For 
sale by Lakeside Publishing Company. 

This little book, as its title page indicates, 
is a simple work on disease germs and how 
to fight them. It is written in simple, popular 
style, in a form suitable for study by public 
school pupils, and for general reading by the 
laity. The health problems of every section 
of the United States have been treated, and 
the author expresses the hope that the book 
may play some part in lessening the appalling 
economic and vital loss from preventable dis- 
ease that is constantly sapping the nation's 
strength. The following subjects are discussed : 
The cells of the body; disease germs and how 
they get into the body; the struggle between 
the body and the germs; the skin; pus-form- 
ing bacteria; tetanus; the air passages and 
Itmgs; the importance of sanitation; the 
house fly ; disease germs in food ; disinfection ; 
unhygienic habits; public sanitation; practical 
sanitation, etc. Besides these the common 
communicable diseases, such as influenza, 
whooping cough, tuberculosis, typhoid fever, 
diphtheria and pneumonia are discussed. Each 
chapter is followed by a list of important 
points to be remembered. To nurses whose 
work calls them into unsanitary homes, school 
nurses and visiting nurses, the book will be 
valuable because of the simplicity in which 
its teachings are given. To principals of 
training schools and head nurses it will be a 
help by calling to mind in concise form points 
often overlooked in teaching probationers. 
On the whole, the little book is one of the 
best of its kind which has come to our notice. 



ber of the American Medical Association, etc. 
Price $1.00, post paid. For sale by the Lake- 
side Publishing Company. 

Professor Irving Fisher, in his report on 
"National Vitality," prepared for the National 
Conservation Commission, estimates that the 
average well man is compelled to lose about 
five days each year as the result of colds, 
headaches and other minor physical disorders. 
Besides the economic loss as the result of 
colds, medical men are now awak.ening to the 
fact that colds in the head, chronic catarrh, 
grippe, etc., are proving to be the forerunners 
in many cases of more severe maladies. It is 
the sincere desire of the author that this little 
book shall contribute something toward a 
sensible understanding of the cause of colds, 
aid in their prevention and materially assist 
in their successful management and treatment 
in accordance with rational rules and scientific 
principles. The book is illustrated with many 
drawings. 



The Cause and Cure of Colds. By William 
S. Sadler, M. D., Professor of Physiologic 
Therapeutics the Post-Graduate Medical 
School of Chicago, Director of the Chicago 
Institute of Physiologic Therapeutics, Mem- 



Health in the Home, A practical work on 
the promotion and preservation of health, with 
illustrated descriptions of Swedish gymnastic 
exercise for home and club practice, by E, 
Marguerite Lindley, Lecturer on Health Cul- 
ture. New and revised edition. Price $i.oa 
For sale by the Lakeside Publishing Com- 
pany. 

The title of this work is a good description 
of its contents, as well as of the range and 
scope of the book, and leaves little more to 
be said. 

The author is a well-known lecturer on 
health subjects, and the book is a full and 
complete embodiment of her ideas absorbed, 
including the ideas of a list of important 
physicians to whom she acknowledges her 
indebtedness. It is printed in a clear and 
readable type, and is well illustrated. The 
work is to be highly recommended. 
(Continued on page 348.) 



Cftt €tiitor*0 letter«bojc 

THE EDITOR IS NOT RESPONSIBLE FOR THE VIEWS OF CONTRIBUTORS 



Dr. MacEvltt'a Advice. 

To the Editor of The Trained Nurse: 

In the September number of The Trained 
Nurse, on page 142, in the article by Dr. 
John C MacEvitt, he gives nurses the fol- 
lowing bit of advice under the title "The 
Responsibilities of Your Vacation": "Your 
first duty is to your patient If you are cer- 
tain that injurious effects will follow the 
literal following out of the doctor's instruc- 
tions, modify them. Obedience to orders is 
admirable, but let it be intelligent in its per- 
formance ♦ * * A nurse with three years' 
hospital experience knows some things which 
a doctor without such hospital experience 
lacks." . 

It is very magnanimous in the doctor to 
include the latter rather flattering statement 
in his article, but I would respectfully ask 
whether such advice is wise for cither a nurse 
or doctor to g^ve. The very thing which the 
doctor advises nurses to do— to modify the 
doctors' orders when, in the nurse's judg- 
ment, to carry out his orders would not be 
for the good of the patient — is one of the 
charges which the doctors in Pennsylvania, 
who are fighting registration, are making con- 
cerning registered nurses. It is an old charge 
which doctors have been making for forty 
years. There is nothing that could do more 
harm to nurses as a body than that they 
should get the view of themselves and their 
responsibilities that the writer seems to wish 
them to have- There are some things better 
left unsaid, and the remarks I have quoted 
would seem to have been among them. I con- 
sider it positively unwise for any doctor to 
tell young nurses that because they have been 
three years in a hospital they know more 
about some things than a doctor— even though 
this may possibly be true in some cases. It 
is a mooted question how far and when a 
nurse is at liberty to set her judgment before 
the doctor's, but the only safe rule to teach 



nurses, it seems to me, is loyalty to the doc- 
tor's orders. Emergencies . call for emergency 
management, and if the doctor had been speak- 
ing of emergencies I would not disagree with 
him. I should like to know what other 
nurses think of the quotation. 

Pennsylvania. 

It is probable that Dr. MacEvitt had 
emergencies in mind when writing the quo- 
tation, though it is not so stated. In these 
days of easy telephone communication, it 
would seem that only a serious emergency 
would justify a nurse in setting her judgment 
before the doctor's without first consulting 
him. When she does so, she should report 
what she has done at the first opportunity. 
There is danger of blundering on both sides 
of carrying out the doctor's orders so literally 
that the patient will die as a result. For in- 
stance, a doctor who had been out late and 
indulging in the cup that cheers wrote an or- 
der for two grains of morphine to be given 
to a baby under two years old. The nurse 
who would carry out such an order, knowing 
that it was an overdose, and the general cir- 
cumstances, would have been equally guilty 
with the doctor who wrote it. But such cases 
are unusual. On the other hand, there is 
danger in advising nurses to set the doctor's 
orders aside whenever they think best. Com- 
mon sense is needed to steer clear of extremes 
at either point. We should advise nurses to 
communicate with the doctor, if at all possible, 
before changing or modifying his orders. 

Ed. 



What Would You Have Done? 

To the Editor of The Trained Nurse: 

When reading an article on "War in Phila- 
delphia Against Registration and Registered 
Nurses" in the June number of The Trained 
Nurse, it brought to my mind a very interest- 
ing pneumonia case which I was called to take 



324 



THE TRAINED NURSE AND HOSPITAL REVIEW 



care of late in February, where one of the 
physicians was decidedly prejudiced against 
trained nurses. Perhaps a few details of the 
case would interest many of my sister nurses 
who are readers of this magazine. 

The call was a special one to me, and it 
was six miles out in the country on a farm. 
The family were evidently in good circum- 
stances, but very ignorant. Upon arriving I 
found the patient had been seriously ill witn 
pneumonia for five days and was in a very 
critical condition. Her heart was very weak, 
rapid, irregular and intermittent. Respiration 
was 45 to 50 per minute, and temperature rang- 
ing from 103 to 105. Both lungs were affected, 
and the patient had neither coughed or raised, 
or had inclination during this time. The hands, 
feet and face were badly cyanosed, also spots 
all over the body that were cyanotic. 

The husband had tried to take care of her, 
which was very evident The physician had 
urged to have a nurse before, but the family 
thought that it was not necessary. The hus- 
band did as well as any ignorant man could 
do. The patient, bed and room were very 
much in need of a nurse's attention. 

I gave the patient my undivided attention 
for seventy-two hours, and in my eagerness 
to save her life, I neglected myself and the 
much needed rest The physician asked me if 
I would like a nurse to help. I replied that I 
could stand it a few hours longer, as the 
patient then was not expected to live very 
much longer. 

There was in the village, six miles away, a 
nurse just finishing on a case, and the physician 
sent for her. The husband also sent for 
another physician to come in consultation. He 
was a friend and doctor for some other mem 
ber of the family. There was not much 
change in the patients condition for three days 
after the second nurse came. After the patient 
did begin to show signs of improvement the 
second nurse was discharged on account of so 
much expense. I took charge of the case alone 
again, and the patient continued improving 
slowly, but not as rapidly as the husband 
thought she ought to, so, after several days, 
he called the same physician in consultation 
again. The pulse was at that time 112 to 116 
and respiration was down to 22 to 26, the 
temperature ranging from 99 to loi, and the 
patient was taking a glass of milk or an egg 



nog every two hours regularly. After the sec- 
ond physician examined her and the charts, he 
said that he could not see any improvement 
whatever, which was untrue. The husband, 
being discouraged, gave the case to the physi- 
cian whom he called in consultation, and dis- 
charged the first one. I had tried to impress 
on the husband's mind how his wife's condi* 
tion had improved, but he failed to see it» so 
I gave up in despair and said no more on the 
subject However, the next time the new 
physician came, I detected a strong odor of 
whiskey about him and knew that he had been 
drinking. 

He immediately ordered me to apply a 
Spanish fly blister over the chest, more par- 
ticularly over the lower lobes of the lungs, 
and after removing to apply a raw cabbage leaf 
over blisters. I was amazed at such treat> 
ment, but I did as he ordered, except putting 
on the cabbage leaf, as there was none avail- 
able in the neighborhood, so a flaxseed poul- 
tice took its place. 

This physician, if I must call him such» was 
not in favor of hypodermics, and the patient's 
medicine had been given that way entirely, as 
her stomach would not retain any medicine 
whatever, except whiskey. He immediately or- 
dered her heart stimulants, which were at 
that time strychnine and digatalin, to be given 
by mouth. After she had taken the second 
dose she vomited, but he was positive that the 
medicine did not cause the vonuting, and 1 
said that we had tried giving it by mouth be- 
fore and that she vomited it up every time, so 
we had to give it hypodermically. Of course 
he did not wish to do as we had been doing, 
so he insisted that it be given by mouth, con- 
sequently vomiting continued. He then ordered 
hard cider to settle her stomach, and this made 
matters worse. Again I thought he was 
crazy, and as I saw that the patient was mak- 
ing no headway under such treatment, and I 
was so disgusted with the physician, for every 
time that he appeared he had been drinking, 
I gave up the case. They then procured the 
services of a domestic nurse, and she went 
away just a few days before the patient died. 

This physician was decidedly prejudiced 
against trained nurses, and a few days before 
I left he was discussing trained nurses with 
the physician who had charge of the case at 
first, and he said that in his experience he 



LETTER BOX 



325 



found that in cases of almost any kind that a 
good practical woman knew more about taking 
care of a patient and proved more satisfactory 
than a trained nurse. The other doctor re- 
plied that that had not been his experience. 

I learned afterward that the patient vomited 
continually up until the last of her life, and 
the end came April 26, 1910. She died in 
convulsions caused by some one of the family 
giving her some pills to quiet her, guessing that 
they were morphine. At the last hours they 
called this physician, but he said he would not 
come, as he could do no good. 

I felt perfectly justified in leaving the case, 
for I could not do differently, and I thought 
that was the easiest way out of the difficulty. 

A friend, who was interested in the case, 
went to the trouble of investigating this doc- 
tor's practice, and found that he was a man 
who dissipated, and had very little practice. 

I presume to say that many nurses have had 
similar experiences with physicians, and their 
treatment of cases, but I never heard of such 
peculiar remedies as this one prescribed. 

G. M. B. 



Nurtet As Dietltlons. 

To the Editor of The Trained Nurse: 

Never having seen an answer to an article 
in the 1909 December number of the Trained 
Nurse and Hospital Review entitled "Nurses 
as Dietitions," I venture, as a nurse, to try to 
give a few words on the subject. However, I 
think the question is practically answered at 
the close of the article, "Because it neither 
brings prestige, or pay;" that is, the pay of an 
average superintendent in a hospital. 

My experience has been in the main, that 
food values, even by so called teachers of 
Dietetics and in text books on the subject, have 
not been sufficiently taught, or impressed on 
the mind of the student. And what effort 
has been made has perhaps not been sufficiently 
appreciated by the pupil, employer, or the 
patient. 

Dr. Thomas, of Philadelphia, has said, 
"Women are poor cooks. Why? Because 
they give you what you like' to eat, and not 
what you ought to have." 

Most nurses are not interested in the diet 
kitchen. Many more having but recently emerged 
from the precinct of a kitchen, radically object 



to such an environment or a return to its duties. 
Just why it is that women so strenuously 
object to the '*fine art" of cooking, is ro. 
known. I believe, however, the answer coul*^ 
be found in the fact that the average woman 
who cooks for any one, other than her own 
people, be she a ladv by birth, education or de- 
portment, is lookei upon as the lowest menial 
in the establishmenr. The French people, pur- 
ported to be the best cooks in the world, are 
proud of being called chef. An American, or 
his amalgamation, would, as a rule, rather 
starve than be called a cook after a few months 
spent in other occupations, much more menia!. 

Who will strive to elevate the occupation? 
It must imply, of course, that the chemis ry 
of food must be properly understood, and ap 
plied. This knowledge ough*^ to be fully equal 
to any chemistry that an ordinary nurse is 
expected to use in her practice, either in a 
hosp'tal or in private practice. A diet kitche» 
properly conducted is a laboratory. If we 
called it such, and made a aosital rule that the 
operator therein should be called a dietition, 
and treated with as much courtesy as a super- 
intendent of any other department, the prob- 
lem, I think, would be solved, and the ranks 
crowded with applicants for positions. 

An Old Nurse. 



Miss Nelsen's Article. 
To the Editor of The Trained Nurse: 

I was much interested in the discussion of 
Miss Nelsen's article, "A Typhoid Case in the 
Country," especially that part bearing on the 
financial consideration. It seems that the 
family in question was situated financially so 
it could, and should, have paid the full amount 
of the bill. Such weeks as Miss Nelsen de- 
scribes take the life and strength out of a 
nurse, and if she is ill or financially embar- 
rassed none of the middle classes that we hear 
so much about, or any one else for that mat- 
ter, comes to her aid. At least I never heard 
of it. Any one to whom a nurse is indebted 
expects remuneration for services, and justly 
so. Why then should nurses be expected to 
give their services for comparatively nothing. 
Perhaps I have not the right ideas, but can 
see it in no other light as yet. 

A Helena Nurse. 



In tfte Jtursiing ^orlti 

ASTICLES IN THIS DEPAKTUBMT, WHKTBEK BBAUNG 8IGNATUBX OK MOT, ABB OOMTBIBirRD. AMD 
DO NOT NECESSABILY BEPBESBNT THB IDBAS QB POLICY OP THIS MAGAZINB 



8panish-Am«rlcan War Nurses. 

The eleventh annual convention of the 
Spanish-American War Nurses was held at 
Atlantic City, N. J., September 20, 21 and 
22. Owing to an alleged breach of contract on 
the part of the Hotel Chalfonte which had been 
selected as headquarters, it was necessary 
to make a change at almost the last moment, 
when the Hotel Westmont was selected for 
this purpose. 

The convention opened on the evening of 
the 20th, with an address by the President, 
Mrs.